Left atrial stiffness and its association to left ventricular geometry in resistance trained athletes using anabolic-androgenic steroids
Bibliographic record
Abstract
Abstract Background Anabolic-Androgenic Steroids (AAS) are commonly used in resistance trained (RT) individuals despite the negative impact on left ventricular (LV) structure and function. Purpose Due to the inter-dependence of the left atrium (LA) and the LV, alongside the importance of the atria contributing to LV filling and cardiac output, this study aimed to assess the relationship between LV geometry and LA stiffness in young RT users of AAS. Methods Utilising a cross-sectional design, male (n=99) and female (n=19) RT individuals aged 29±6yrs were grouped based on self-reported AAS user status: current (CU; n=70), past (PU; n=22) and non-users (NU; n=27). All participants underwent transthoracic echocardiography with strain imaging. Left ventricular geometry was defined based on LV mass index and relative wall thickness as per European Association of Cardiovascular Imaging guidelines. Left atrial stiffness index (LASi) was calculated as the ratio of E/E’ to LA reservoir strain (LARes) and concentricity as the ratio of LV mass to end-diastolic volume^0.67. Ejection Fraction (EF) was calculated using Simpsons biplane method. All data was presented as mean ± standard deviation with group differences assessed using a one-way ANOVA with post-hoc Bonferroni adjustment and Kruskal-Wallis test for non-normally distributed indices. A Fishers exact test was used to compare geometry between groups. Relationships between LASi and concentricity were assessed using multi linear regression Results Current users presented greater LV remodelling compared to PU and NU (eccentric hypertrophy (45%, 9% and 0%), concentric remodelling (2%, 0% and 0%) and concentric hypertrophy (8%, 0% and 0% respectively; p<0.001). EF was lower in those with concentric (52±9, p=.006) and eccentric (53±5, p<.001) hypertrophy than with normal geometry (58±5), but no difference between concentric and eccentric hypertrophy. LARes was lower in CU (32.0±7.5) compared to PU (39.1±8.3, p=.001) and NU (40.2±7.7, p<.001). E/E’ and LASi were higher in CU than PU (p=.006, p=.001) and NU (p<.001, p<.001; E/E’: 6.7±1.8, 5.9±1.5, and 5.7±1.4; LA stiffness index: 0.21±0.08, 0.16±0.05, and 0.15±0.05). Concentricity was higher in CU than PU (p<.001) and NU (p<.001; 8.3±2.2; 6.4±1.4 and 5.7±2.2 respectively). Controlling for user status, concentricity predicted LASi (R²=0.23, F(2,109)=16.1, p<.001) with a 0.1 increase in LASi for each 10g.ml^-0.667 increase in concentricity. Conclusions Although current users of AAS presented with more eccentric hypertrophy, those with increased concentricity and concentric hypertrophy had higher LA stiffness index. These data highlight 1) the potential greater negative functional impact of concentric compared to eccentric hypertrophy in young RT individuals using AAS, 2) the added value of LASi above conventional indices such as EF and 3) the possible reversible nature of LV and LA remodelling following cessation of AAS use.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".