Cardiac autonomic dysfunction in anabolic steroid users.

Area of Science:

• Cardiology
• Sports Medicine
• Autonomic Neuroscience

Background:

• Androgenic-anabolic steroids (AAS) are performance-enhancing drugs with known cardiovascular risks.
• Cardiac autonomic dysfunction is linked to adverse cardiovascular outcomes.
• Recreational athletes may abuse AAS without medical supervision.

Purpose of the Study:

• To investigate the potential for androgenic-anabolic steroid (AAS) abuse to induce cardiac autonomic dysfunction.
• To compare autonomic function between recreational athletes using AAS and a control group.

Main Methods:

• Twenty-two male recreational trained subjects participated, with 11 in the AAS group (410 ± 78.6 mg/week).
• All subjects underwent submaximal exercise testing (Astrand-Rhyming protocol) with continuous electrocardiogram (ECG) and respired gas analysis.
• Heart rate variability (HRV) analysis was performed using MATLAB-based algorithms on ECG data at rest, during, and post-exercise.

Main Results:

• At rest, the AAS group exhibited significantly lower HRV parameters including standard deviation of R-R intervals, pNN50, RMSSD, and spectral powers (LF, HF) compared to controls.
• Post-exercise, the AAS group showed reduced pNN50, RMSSD, and HF, alongside an elevated LF/HF ratio, indicating sympathetic-parasympathetic imbalance.
• Elevated resting VO2, VCO2, and VE were observed in the AAS group.

Conclusions:

• Supraphysiological doses of AAS appear to induce tonic cardiac autonomic dysfunction in recreational trained subjects.
• AAS abuse is associated with impaired cardiac autonomic regulation, evident both at rest and during physiological stress.
• These findings highlight potential cardiovascular risks associated with AAS use in non-elite athletes.