Endocrine Abstracts

Background and Aim: Ongoing anabolic androgenic steroids (AAS) use has been linked with left ventricle dysfunction, while information on the effects years after discontinuation is limited. Furthermore, the underlying mechanism behind the impaired cardiac function is unknown. Early signs of cardiomyopathy, such as microvascular dysfunction with global or regional reduced myocardial perfusion can be measured noninvasively by cardiac positron emission tomography (PET) with Rubidium-82 (Rb-82). The aim of this study was to assess myocardial flow reserve (MFR) by PET/CT Rb-82 in current and previous AAS users compared with healthy never user control participants.

Methods: Community-based cross-sectional study including men involved in recreational training. A standard cardiac PET/CT Rb-82 was performed at rest and after adenosine stress-induced. History of AAS use was obtained using a standardized questionnaire. A MFR<2.5 was used as a validated definition of impaired in men without obstructive coronary artery disease.

Results: We included 28 current and 22 former AAS users and 14 recreational athletes with no prior AAS use. The mean (SD) age was 33 (9) years. Accumulated duration of AAS use, geometric mean (95 CI%) was 184 (108; 312) weeks among current users and 99 (52; 187) weeks among former users (P=0.126). Duration since AAS cessation, geometric mean (95 CI%) was 17 months (10; 28,) and 13 (59%) former users discontinuated AAS more than one year prior to inclusion. Analyzed as continuous variable, both former and current users exhibited lower mean (SD) MFR, 3.1 (0.9) (P=0.028) and 3.3 (1.2) vs 4.1 (0.9) (P=0.046) as compared with controls of never users. The prevalence of impaired MFR (<2.5) was increased in former and current AAS users compared with controls, 36% and 25% vs 7%, trend test (P=0.026). Among previous users, every doubling of accumulated AAS duration was associated with an increased risk of impaired MFR age-adjusted OR of 2.9 [1.05; 810] (P=0.039).

Conclusions: Previous and current users of AAS exhibited impaired MFR, suggesting persistent impaired cardiac microcirculatory function.