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Article

Early Left Ventricular Diastolic Dysfunction, Reduced Baroreflex Sensitivity, and Cardiac Autonomic Imbalance in Anabolic–Androgenic Steroid Users

Sports Medicine Laboratory, Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
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Academic Editors: Hadi Nobari, Jorge Pérez-Gómez and Juan Pedro Fuentes García
Int. J. Environ. Res. Public Health 2021, 18(13), 6974; https://doi.org/10.3390/ijerph18136974
Received: 27 May 2021 / Revised: 18 June 2021 / Accepted: 25 June 2021 / Published: 29 June 2021
(This article belongs to the Special Issue Training for Optimal Sports Performance and Health)
The effects of androgen anabolic steroids (AAS) use on athletes’ cardiac autonomic activity in terms of baroreflex sensitivity (BRS), and heart rate variability (HRV) have not yet been adequately studied. Furthermore, there is no information to describe the possible relationship between the structural and functional cardiac remodeling and the cardiac autonomic nervous system changes caused by AAS abuse. Thus, we aimed to study the effects of long-term AAS abuse on cardiac autonomic efficacy and cardiac adaptations in strength-trained athletes. In total, 80 strength-trained athletes (weightlifters and bodybuilders) participated in the study. Notably, 40 of them using AAS according to their state formed group A, 40 nonuser strength-trained athletes comprised group B, and 40 healthy nonathletes (group C) were used as controls. All subjects underwent a head-up tilt test using the 30 min protocol to evaluate the baroreflex sensitivity and short HRV modulation. Furthermore, all athletes undertook standard echocardiography, a cardiac tissue Doppler imaging (TDI) study, and a maximal spiroergometric test on a treadmill to estimate their maximum oxygen consumption (VO2max). The tilt test results showed that group A presented a significantly lower BRS and baroreflex effectiveness index than group B by 13.8% and 10.7%, respectively (p < 0.05). Regarding short-term HRV analysis, a significant increase was observed in sympathetic activity in AAS users. Moreover, athletes of group A showed increased left ventricular (LV) mass index (LVMI) by 8.9% (p < 0.05), compared to group B. However, no difference was found in LV ejection fraction between the groups. TDI measurements indicated that AAS users had decreased septal and lateral peak E’ by 38.0% (p < 0.05) and 32.1% (p < 0.05), respectively, and increased E/E’ by 32.0% (p < 0.05), compared to group B. This LV diastolic function alteration was correlated with the year of AAS abuse. A significant correlation was established between BRS depression and LV diastolic impairment in AAS users. Cardiopulmonary test results showed that AAS users had significantly higher time to exhaustion by 11.0 % (p < 0.05) and VO2max by 15.1% (p < 0.05), compared to controls. A significant correlation was found between VO2max and LVMI in AAS users. The results of the present study indicated that long-term AAS use in strength-trained athletes led to altered cardiovascular autonomic modulations, which were associated with indices of early LV diastolic dysfunction. View Full-Text
Keywords: anabolic–androgenic steroids; athletes; baroreflex sensitivity; cardiac autonomic nervous system; cardiac function anabolic–androgenic steroids; athletes; baroreflex sensitivity; cardiac autonomic nervous system; cardiac function
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MDPI and ACS Style

Kouidi, E.J.; Kaltsatou, A.; Anifanti, M.A.; Deligiannis, A.P. Early Left Ventricular Diastolic Dysfunction, Reduced Baroreflex Sensitivity, and Cardiac Autonomic Imbalance in Anabolic–Androgenic Steroid Users. Int. J. Environ. Res. Public Health 2021, 18, 6974. https://doi.org/10.3390/ijerph18136974

AMA Style

Kouidi EJ, Kaltsatou A, Anifanti MA, Deligiannis AP. Early Left Ventricular Diastolic Dysfunction, Reduced Baroreflex Sensitivity, and Cardiac Autonomic Imbalance in Anabolic–Androgenic Steroid Users. International Journal of Environmental Research and Public Health. 2021; 18(13):6974. https://doi.org/10.3390/ijerph18136974

Chicago/Turabian Style

Kouidi, Evangelia J., Antonia Kaltsatou, Maria A. Anifanti, and Asterios P. Deligiannis 2021. "Early Left Ventricular Diastolic Dysfunction, Reduced Baroreflex Sensitivity, and Cardiac Autonomic Imbalance in Anabolic–Androgenic Steroid Users" International Journal of Environmental Research and Public Health 18, no. 13: 6974. https://doi.org/10.3390/ijerph18136974

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