Heart failure & cardiomyopathiesCross-sectional study

Severe biventricular cardiomyopathy in both current and former long-term users of anabolic–androgenic steroids

Eur J Prev CardiolPublished

  • Cross-sectional study

Authors' conclusion

Long-term AAS users showed severely biventricular cardiomyopathy. The reduced systolic function was also found upon discontinued use.

Study context

Population
Weightlifters, current and former long-term anabolic-androgenic steroid (AAS) users and non-using controls
Participants
101 vs 71
Exposure
Long-term AAS users vs non-using weightlifting controls
  • AAS usersn = 101
  • Weightlifting controls (WLC)n = 71reference
Outcome
Cardiovascular effects (echocardiography) of long-term AAS use; occurrence of severely reduced myocardial function

Main finding

As reported in the abstract

Echocardiography and BP, AAS users vs WLC
GroupLV mass indexLeft ventricular ejection fraction (LVEF)RV global longitudinal strainSBP
AAS users106 ± 26 g/m²49 ±7%−17.3 ± 3.5%141 ± 17 mmHg
WLC80 ± 15 g/m²59 ± 5%−22.8 ± 2.0%133 ± 11 mmHg

Observational data: associations, not effects.

Further findings

Severely reduced myocardial function (LVEF ≤40%), current vs former users · not significant (NS)

Severely reduced myocardial function (LVEF ≤40%), current vs former users — left ventricular mass index (LVMI) and LVEF pathological in current and former users vs WLC
P < 0.05

Estimated lifetime AAS dose (current users)

Correlated with reduced LVEF and LVGLS
P < 0.05
Not correlated with LVMI
P = 0.12

Determinant of reduced LVEF (regression, total population)

History of AAS use strongest determinant, not strength training or hypertension
β −0.53, P < 0.001

Original publication

Severe biventricular cardiomyopathy in both current and former long-term users of anabolic–androgenic steroids. Eur J Prev Cardiol. Published 22 November 2023. doi:10.1093/eurjpc/zwad362

Summarised from the published abstract; every number is checked against it