Early myocardial dysfunction after chronic use of anabolic androgenic steroids: combined pulsed-wave tissue Doppler imaging and ultrasonic integrated backscatter cyclic variations analysis.
BACKGROUND
The chronic consumption of androgenic anabolic steroids (AAS) has shown to cause subclinical impairment of myocardial function. Pulsed-wave Doppler tissue imaging (PWDTI) detects early regional alterations of ventricular function, whereas integrated backscatter cyclic variations (IBScv) are tightly related to the contractile efficiency of the left ventricular wall. The aim of this study was to identify the effects of chronic AAS misuse on myocardial function using both PWDTI and IBScv.


METHODS
Twenty-eight male bodybuilders (11 AAS users, 17 AAS nonusers) and 20 healthy sedentary subjects (controls), matched according to age, were studied. To assess left ventricular function, each subject underwent standard Doppler echocardiography, PWDTI, and IBScv analyses.


RESULTS
Left ventricular mass was significantly higher in AAS users than in AAS nonusers and controls. Global systolic function (assessed by determining the ejection fraction) was similar in all subjects, but isovolumetric relaxation time was significantly higher in AAS users than in controls. On PWDTI analysis, AAS users showed regional systolic and diastolic dysfunction (evaluated by measuring s', e', and a') not detectable in the other two groups. IBScv identified regional systolic impairment only in AAS users at the level of the left ventricular inferior wall.


CONCLUSIONS
The present study confirms that in AAS users, PWDTI and IBScv are effective and reliable noninvasive diagnostic tools for detecting early abnormalities of the systolic and diastolic longitudinal myocardial function, probably related to an increase in myocardial collagen content, interpretable as a repair process against the direct cellular injury produced by AAS.
Montisci
Roberta
R
Clinical Cardiology, University of Cagliari, Cagliari, Italy.
Cecchetto
Giovanni
G
Ruscazio
Massimo
M
Snenghi
Rossella
R
Portale
Anna
A
Viel
Guido
G
Nalesso
Alessandro
A
Paoli
Antonio
A
Iliceto
Sabino
S
Meloni
Luigi
L
Ferrara
Santo Davide
SD
Montisci
Massimo
M
D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D000728:Androgens / Q000009:adverse effects*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013256:Steroids / Q000009:adverse effects*; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000000981:diagnostic imaging*
D045930:Anabolic Agents; D000728:Androgens; D013256:Steroids