Arrhythmias & electrophysiologyDiagnostic or prognostic study
Evaluating Electrocardiographic (ECG) Criteria for Diagnosing Left Ventricular Hypertrophy in Anabolic-Androgenic Steroid Users
- diagnostic performance study
Authors' conclusion
ECG was insufficient for identifying echocardiographic LVH in AAS users who represent a high-risk cardiovascular population. Routine specialist evaluations, including echocardiography, should be considered for long-term AAS users to facilitate early detection of LVH and associated dysfunctions.
Study context
- Population
- Long-term male anabolic-androgenic steroid (AAS) userswith echocardiographic LVH 32 · without echocardiographic LVH 68
- Participants
- 100 male AAS users
- Comparison
- Six ECG-LVH criteria against echocardiography as the reference standard
- echocardiographic LVHn = 32
- without echocardiographic LVHn = 68
Performance
As reported in the abstract
Left ventricular (LV) ejection fraction ≤40%
P = 0.02
Further findings
| Outcome | echocardiographic LVH | without echocardiographic LVH | P value |
|---|---|---|---|
| LV global longitudinal strain · more impaired with LVH | −14.7% ± 2.7% | −16.5% ± 2.2% | P = 0.002 |
- Diagnostic performance of ECG-LVH criteria: Peguero-Lo Presti sensitivity 31% · specificity 88% · undetected 69%
- Diagnostic performance of ECG-LVH criteria: Romhilt-Estes (cutoff of 5) sensitivity 34% · specificity 85% · undetected 66%
Diagnostic performance of ECG-LVH criteria
- Peguero-Lo Presti provided the best balance between sensitivity and specificity among voltage-based indices
Original publication
Evaluating ECG Criteria for Diagnosing Left Ventricular Hypertrophy in Anabolic-Androgenic Steroid Users. JACC Adv. Published 14 January 2026. doi:10.1016/j.jacadv.2025.102499
Summarised from the published abstract; every number is checked against it