Arrhythmias & electrophysiology
Evaluating Electrocardiographic (ECG) Criteria for Diagnosing Left Ventricular Hypertrophy in Anabolic-Androgenic Steroid Users
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) users
- Participants
- 100 male AAS users
- Comparison
- Six ECG-LVH criteria against echocardiography as the reference standard
- Echocardiographic LVHn = 32
- Without echocardiographic LVHn = 68
- Outcome
- Left ventricular (LV) ejection fraction ≤40%
Performance
As reported in the abstract
P = 0.02
Further findings
| Outcome | Echocardiographic LVH | Without echocardiographic LVH | P value |
|---|---|---|---|
| LV global longitudinal strainMore 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.
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