The impact of anabolic androgenic steroids abuse and type of training on left ventricular remodeling and function in competitive athletes

Ivan Ilić; Vitomir Djordjević; Ivan Stanković; Alja Vlahović-Stipac; Biljana Putniković; Rade Babić; Aleksandar N. Nešković

doi:10.2298/3716

Ivan Ilić Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Vitomir Djordjević Health Center Dr. Ristić, Belgrade, Serbia
Ivan Stanković Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Alja Vlahović-Stipac Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Biljana Putniković Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Rade Babić Dedinje Cardiovascular Institute, Belgrade, Serbia
Aleksandar N. Nešković Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

DOI: https://doi.org/10.2298/3716

Keywords: athletes, substance-related disorders, androgens, ventricular remodeling, risk assessment, echocardiography,

Abstract

Background/Aim. Long-term intensive training is associated with distinctive cardiac adaptations which are known as athlete’s heart. The aim of this study was to determine whether the use of anabolic androgenic steroids (AAS) could affect echocardiographic parameters of left ventricular (LV) morphology and function in elite strength and endurance athletes. Methods. A total of 20 elite strength athletes (10 AAS users and 10 non-users) were compared to 12 steroid-free endurance athletes. All the subjects underwent comprehensive standard echocardiography and tissue Doppler imaging. Results. After being indexed for body surface area, both left atrium (LA) and LV end-diastolic diameter (LVEDD) were significantly higher in the endurance than strength athletes, regardless of AAS use (p < 0.05, for both). A significant correlation was found between LA diameter and LVEDD in the steroid-free endurance athletes, showing that 75% of LA size variability depends on variability of LVEDD (p < 0.001). No significant differences in ejection fraction and cardiac output were observed among the groups, although mildly reduced LV ejection fraction was seen only in the AAS users. The AAS-using strength athletes had higher A-peak velocity when compared to steroid-free athletes, regardless of training type (p < 0.05 for both). Both AAS-using and AAS-free strength athletes had lower e’ peak velocity and higher E/e’ ratio than endurance athletes (p < 0.05, for all). Conclusions. There is no evidence that LV ejection fraction in elite athletes is altered by either type of training or AAS misuse. Long-term endurance training is associated with preferable effects on LV diastolic function compared to strength training, particularly when the latter is combined with AAS abuse.

Author Biographies

Ivan Ilić, Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Cardiology department, Cardiac catheterization laboratory, attending physician

Vitomir Djordjević, Health Center Dr. Ristić, Belgrade, Serbia

attending cardiologist

Ivan Stanković, Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Cardiology department, attending physician

Alja Vlahović-Stipac, Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Cardiology department, Cardiac catheterization laboratory, attending physician

Biljana Putniković, Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Cardiology department, Head

Rade Babić, Dedinje Cardiovascular Institute, Belgrade, Serbia

Cardiac catheterization laboratory, attending physician

Aleksandar N. Nešković, Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Clinic for internal medicine, Head

Cardiac catheterization laboratory, Head

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