Endocrine Abstracts

JOINT695

Background and aim: Impaired myocardial microcirculation, measured by myocardial flow reserve (MFR) has recently been demonstrated in male androgenic steroid (AAS) users. Illicit use of AAS has disseminated to women, though the knowledge on the impact on cardiac function is virtually none. Therefore, the purpose of this study was to investigate cardiac microcirculation and systolic function in current and former female AAS users and compare with female controls with no former AAS use. Coronary artery calcium score was assessed as a secondary outcome.

Methods: This cross-sectional study included recreational strength trained females who were grouped according to their history of illicit AAS use. MFR was investigated using rest and adenosine stressed cardiac rubidium 82 (⁸²Rb) positron emission tomography/computed tomography (PET/CT). Impaired and subclinical impaired myocardial microcirculation was evaluated using cutoffs of MFR less than 2 and less than 2.5, respectively. Left ventricular ejection fraction (LVEF) was evaluated at rest and during stress, and as LVEF-reserve, calculated as LVEF-stress minus LVEF-rest. Coronary artery calcium score was determined from a non-contrast breath-hold CT.

Results: A total of 54 women, 20 current users (mean (S.D.): 34 (10) years), 17 former users (37 (9) years) and 17 controls (37 (8) years) were included. The accumulated use of AASs were similar between current users (median (IQR): 58 (13–166) weeks) and former users (58 (33–117.5) weeks, P=0.67). There were no differences in mean MFR between groups (P=0.79). Further, the prevalence of impaired MFR (current users: n=1 (5.0%), former users: n=1 (5.9%), controls: n=0 (0.0%), P>0.99), and subclinical impaired MFR (current users: n=3 (15.0%), former users: n=2 (11.8%), controls: n=3 (17.6%), P>0.99) did not differ between groups. Mean (S.D.) LVEF-rest and LVEF-stress was reduced in current users (64 (7) % and 72 (7) %) compared to controls (70 (6) %, P=0.01 and 78 (19) %, P=0.01). In contrast, no significant differences were observed in LVEF-rest and LVEF-stress between former users (68 (5) %, P=0.47 and 75 (4) %, P=0.47) and controls. No differences were detected in LVEF-reserve (P=0.92) and coronary artery calcium score (median (range): current users: 0 (0–2.5), former users: 0 (0–44), controls: 0 (0–0), P=0.14) between the three groups.

Conclusion: In this study, there were no group differences in MFR and coronary artery calcium score. However, an impaired left ventricular function demonstrated by a reduced LVEF-rest and LVEF-stress, was found among current female users of AASs compared to female controls.