Comparison of Left Atrial Function in Long-Term Anabolic/Androgenic Steroid Users versus Nonuser Bodybuilders by Using Two-Dimensional Speckle-Tracking Echocardiography

Abstract

Introduction: Long-term illicit use of supraphysiological doses of anabolic/androgenic steroids (AAS) may cause pathological left ventricular hypertrophy (LVH), diastolic dysfunction, left atrial (LA) hypertrophy, increased myocardial stiffness, and myocardial fibrosis. Therefore, distinguishing AAS-using athlete’s hearts from the nonpathological “athlete’s heart” is critically important. The aim of this study was to evaluate LA myocardial function using 2D-STE method in both AAS-using and drug-free bodybuilders, and assess its potential role in the differential diagnosis between these two entities.

Patients and Methods: We selected a population of 33 male, competitive bodybuilders, including 15 actively using AAS for > 2 years (users) and 18 who had never used AAS (nonusers).

Results: AAS users had a significantly lower global LA strain reservoir (GLAS-R), global LA strain during early diastole (GLAS-E; 38.2 ± 8.4 vs. 48.6 ± 11.9, p< 0.01; 24.4 ± 8.6 vs. 37.1 ± 12.8, p< 0.01; respectively), global LA strain rate reservoir (GLASR-R), global LA strain rate during early diastole (GLASR-E; 1.8 ± 0.3 vs. 2.2 ± 0.4, p< 0.01; -1.4 ± 0.2 vs. -1.8 ± 0.3, p< 0.01; respectively) than nonusers. The univariate correlation analysis demonstrated that GLAS-R, GLAS-E, GLASR-R, and GLASR-E had a good inverse correlation with E/Em (r: -0.34, p= 0.04; r: -0.35, p= 0.04; r: -0.35, p= 0.04, and r: -0.35, p= 0.04, respectively).

Conclusion: The present study confirms that LA strain and strain rate are impaired in AAS users compared to nonusers and provide valuable additional information to that obtained by conventional echocardiography in the differential diagnosis between pathological and physiological LVH.

Keywords

• Anabolic/androgenic steroid,bodybuilder athletes,left atrial function,speckle tracking,left atrial strain

Uzun Dönem Anabolik-Androjenik Steriod Kullanan ve Kullanmayan Vücut Geliştiricilerde Sol Atrial Fonksiyonların İki Boyutlu Benekli İşaretleme Ekokardiyografik Yöntemi ile Karşılaştırılması

Abstract

Giriş: Uzun dönem ve yüksek dozda anabolik-androjenik steriod (AAS) kullanımı sol ventirkül patalojik hipertrofisine (SVH), diyastolik disfonksiyona, sol atrium (SA) hipertrofisine, miyokart sertlik ve fibrozisinde artmaya neden olur. Bundan dolayı AAS kullanan sporcuların patolojik olmayan “sporcu kalbi”inden ayrımı kritik öneme sahiptir. Bu çalışmanın amacı SA miyokart fonksiyonlarının iki boyutlu benekli ekokardiyografik yöntem ile AAS kullanan ve kullanmayan vücut geliştiricilerde değerlendirilmesi ve bu yöntemin bu iki durumun ayrımında kullanılmasıdır.

Hastalar ve Yöntem: Çalışmamıza 15’i aktif olarak AAS kullanan (> 2 yıl) ve 18’i hiç AAS kullanmayan hepsi erkek olan toplam 33 yarışımcı vücut geliştirici alındı.

Bulgular: AAS kullanan atletlerin global SA strain reservoir (GLAS-R), global SA erken diyastol strain (GLAS-E) (38.2 ± 8.4 vs. 48.6 ± 11.9, p< 0.01; 24.4 ± 8.6 vs. 37.1 ± 12.8, p< 0.01; sırasıyla), global SA strain rate reservoir (GLASR-R), global SA erken diyastol strain rate (GLAS-E) (1.8 ± 0.3 vs. 2.2 ± 0.4, p< 0.01; -1.4 ± 0.2 vs. -1.8 ± 0.3, p< 0.01; sırasıyla) değerlerinin kullanmayan sporculara göre önemli ölçüde azaldığı görüldü. Univaryant korelasyon analizi GLAS-R, GLAS-E, GLASR-R ve GLASR-E değerlerinin E/Em (r: -0.34, p = 0.04; r: -0.35, p= 0.04; r: -0.35, p= 0.04 and r: -0.35, p= 0.04, sırasıyla) ile ters korelasyon olduğunu gösterdi.

Sonuç: Bu çalışma SA strain ve strain rate değerlerinin AAS kullanan sporcularda kullanmayan sporculara göre azaldığı, ayrıca patolojik ve fizyolojik SVH ayırıcı tanısında konvansiyonel ekokardiyografi ile elde edilen bulgulara ek değerli bilgiler sağladığı doğrulanmıştır.

Keywords

• Anabolik-androjenik steroid,vücut geliştirici sporcular,sol atrial fonksiyon,benekli işaretleme,sol atrial strain

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