title: Comparison of Right Ventricle Systolic Function between Long-Term Anabolic-Androgenic Steroid User and Nonuser Bodybuilder Athletes: A Study of Two-Dimensional Speckle Tracking Echocardiography.
abstract: BACKGROUND
  Right ventricular (RV) effects of long-term use of anabolic-androgenic steroids (AAS) are not clearly known. The aim of this study was to assess RV systolic functions by two-dimensional speckle tracking echocardiography (2DSTE) in AAS user and nonuser bodybuilders.
  
  
  METHODS
  A total of 33 competitive male bodybuilders (15 AAS users, 18 AAS nonusers) were assessed. To assess RV systolic functions, all participants underwent standard two-dimensional and Doppler echocardiography, and 2DSTE.
  
  
  RESULTS
  Interventricular septal thickness, left ventricle posterior wall thickness, relative wall thickness, and left ventricle mass index were significantly higher in AAS users than nonusers. While standard diastolic parameters were not statistically different between the groups, tissue Doppler parameters including RV E' and E'/A' were lower in AAS users than nonusers (10.1 ± 2.0 vs. 12.7 ± 2.1; P = 0.001, 1.1 ± 0.1 vs. 1.5 ± 0.4; P = 0.009, respectively). Tricuspid annular plane systolic excursion, RV fractional area change, and RV S' were in normal ranges. However, RV S' was found to be lower in users than nonusers (12.2 ± 2.2 vs. 14.6 ± 2.8, P = 0.011). RV free wall longitudinal strain and strain rate were decreased in AAS users in comparison with nonusers (-20.2 ± 3.1 vs. -23.3 ± 3.5; P = 0.012, -3.2 ± 0.1 vs. -3.4 ± 0.1; P = 0.022, respectively). In addition, there were good correlations between 2DSTE parameters and RV S', E', and E'/A'.
  
  
  CONCLUSIONS
  Despite normal standard systolic echo parameters, peak systolic RV free wall strain and strain rate were reduced in AAS user bodybuilders in comparison with nonusers. Strain and strain rate by 2DSTE may be useful for early determination of subclinical RV dysfunction in AAS user bodybuilders.
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Elnur
authors.initials: E
authors.lastname: Alizade
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Anil
authors.initials: A
authors.lastname: Avci
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Mehmet Mustafa
authors.initials: MM
authors.lastname: Tabakcı
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Toprak
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Regayip
authors.initials: R
authors.lastname: Zehir
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Goksel
authors.initials: G
authors.lastname: Acar
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kargin
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Mehmet Yunas
authors.initials: MY
authors.lastname: Emiroğlu
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akçakoyun
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
mesh_terms: D000728:Androgens / Q000009:adverse effects*; D004452:Echocardiography / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D058573:Performance-Enhancing Substances / Q000009:adverse effects*; D064797:Physical Conditioning, Human / Q000009:adverse effects*; D013318:Stroke Volume / Q000187:drug effects; D045165:Testosterone Congeners / Q000009:adverse effects*; D013812:Therapeutics; D018497:Ventricular Dysfunction, Right / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D000728:Androgens; D058573:Performance-Enhancing Substances; D045165:Testosterone Congeners
keywords: anabolic-androgenic steroid; bodybuilder athletes; speckle tracking echocardiography; strain; strain rate