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

Yıl 2017, Cilt: 20 Sayı: 3, 185 - 194, 03.12.2017

Elnur Alizade

Öz

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.

Anahtar Kelimeler

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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