International Journal of Cardiovascular Sciences. 29/abr/2025;38:e20240193.

Systolic Subclinical Dysfunction in Anabolic Steroid Users: A Real Life Study

Renata Rodrigues Teixeira De Castro , Marcello de Brito Campos , Luiz Mello, João Giffoni Silveira Neto

DOI: 10.36660/ijcs.20240193

Este Artigo Original é referido pelo Editorial "Anabolic-Androgenic Steroids and Cardiotoxicity".

Abstract

Background:

Considering the uncertainty regarding the cardiovascular safety of anabolic steroid use, we believe that the use of advanced echocardiography techniques, such as speckle tracking, may contribute more objectively to the analysis of cardiotoxicity induced by these substances.

Objectives:

To compare, through speckle tracking, the echocardiograms of bodybuilders who abuse anabolic steroids with those who do not use these substances.

Methodology:

This work is a retrospective, observational study that analyzed echocardiograms performed on bodybuilders followed up in an outpatient sports cardiology service, comparing the results between individuals who use and those who have never used anabolic steroids. Continuous data was compared, using unpaired, two-tailed, Student’s T test, with a p-value < 0.05 considered to be significant.

Results:

The final sample of this study included 22 bodybuilders, 14 of whom were anabolic steroid users (UAS) and 8 non-users of anabolic steroids (NUAS). All 22 participants had a left ventricular ejection fraction (LVEF) > 50% (UAS = 55±4 vs. NUAS = 63±1%; p < 0.001). All 14 steroid users showed abnormal global longitudinal strain (GLS), while all 8 non-users presented normal values for this variable (UAS = 13±2 vs. NUAS = 20±2; p < 0.01).

Conclusion:

Bodybuilders who use anabolic steroids, despite having normal values for conventional echocardiography parameters, show a reduction in GLS of the left ventricle. The use of speckle-tracking echocardiography represents an important tool in the analysis of myocardial injury in UAS, offering the possibility of early detection of systolic dysfunction in these individuals.