Bi-ventricular structure and function in resistance trained athletes using anabolic androgenic steroids as determined by three-dimensional echocardiography
Bibliographic record
Abstract
Abstract Background Anabolic androgenic steroids (AAS) are frequently used by resistance trained (RT) individuals and their use has been shown to have a negative impact on left ventricular (LV) structure and function albeit with limited evidence pertaining to the impact on the right ventricle (RV). Three-dimensional echocardiography (3DE) is preferred over two-dimensional imaging for better delineating ventricular structure alongside providing capacity for 3DE derived strain imaging. Purpose To determine 3DE derived bi-ventricular structure and function in RT athletes in 1) current users (CU), 2) past users (PU) and 3) non-users (NU) of AAS. Methods Thirty-four RT athletes (28 male and 6 female) (>4hrs dedicated RT per week) were recruited into the study. Athletes self-reported as CU (n=14), PU (n=9) and NU (n=11). All athletes underwent assessment of anthropometrics (height, weight and fat free mass (FFM), blood pressure and 3DE to obtain measures of LV structure (LV end diastolic volume (EDV) and LV mass (LVM)) and function (LV ejection fraction (EF), global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global area strain (GAS) and torsion and RV structure (RV EDV) and function (RV EF and tricuspid plane systolic excursion (TAPSE)). All structural indices were scaled to FFM. Results Participant demographics are presented in figure 1. CU had significantly larger absolute values of both LV and RV size (cavity and mass) compared to both PU and NU however these differences disappeared when scaled to FFM (LV mass = 2.5±0.3 vs 2.3±0.3 and 2.4±0.3 g/kg, LV EDV = 2.3±0.2 vs 2.3±0.2 and 2.3±0.2 ml/kg, RV EDV = 1.0±0.7 vs 1.2±0.8 and 1.3±0.5 ml/kg; P<0.05 for CU, PU and NU respectively). Left ventricular function was reduced in CU compared to both PU and NU and PU to NU for GLS (-10.9±2 vs -12.6±1 and -15.3±1.5 %; P<0.05), GAS (-21.8±4.4 vs -23.4±2.3 and -27.5±1.7 %; P<0.05), GRS (30.7±7.5 vs 32.9±4.5 and 41±3.9 % and EF (50±5 vs 52±3 and 56±3 %; P<0.05 for CU, PU and NU respectively) (see figure 2). There were no significant differences between any group for LV torsion and GCS or RV EF and TAPSE. Conclusions 3DE provides unique insight into bi-ventricular structure and function in RT athletes using AAS. The bi-ventricular enlargement seen in CU normalises when scaled to FFM and highlights a proportional increase in cardiac size to meet the metabolic requirements from elevated skeletal muscle mass. The reductions in LV GLS, GRS, GAS and EF without changes in RV function suggest a deleterious impact of AAS on LV but not RV function. The LV functional differences are also apparent in PU, and therefore, these findings suggest a possible permanent negative impact on LV function from AAS use. Further larger studies using 3DE in this population are warranted to further explore these findingsFigure 1 Figure 2
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".