Background: Left ventricular (LV) remodeling, characterized by increased LV hypertrophy and depressed function, is observed in strength-trained athletes who use anabolic-androgenic steroids (AAS). Previous studies reported an increase in cardiac fibrosis in these athletes, which could promote intraventricular dyssynchrony. In this context, this study evaluated LV dyssynchrony in strength-trained athletes using AA; hypothesizing that the use of AAS leads to an increase in LV dyssynchrony with an increase in post-systolic shortening. Methods: Forty-four participants (aged 20-40 years) were divided into three age-matched groups: strength-trained athletes using AAS (users, n=14) and those who were not (non-users, n=15), and healthy sedentary men (controls, n=15),. After completing a survey, each participant was assessed with 2D-strain echocardiography. Left ventricular dyssynchrony was quantified using the standard deviation of the time to peak for longitudinal strains (SD), the longitudinal strain delay index (LSDI) and the segmental post-systolic index (PSI). Results: Users exhibited a greater LV mass index and higher systolic and diastolic functions than both controls and non-users. The decrease in LV strains in users was predominantly observed at the interventricular segments. The SD, LSDI and PSI, calculated on the basal inferoseptal, basal anteroseptal and basal inferolateral segments, were higher in users. Conclusion: The results strongly support that the specific LV remodeling observed in young AAS users was associated with an increase in LV dyssynchrony. The correlations with ejection fraction suggested that wasted energy, due to post-systolic shortenings, contributed in part to the decrease in LV function in strength-trained athletes using AAS.

中文翻译：

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使用合成代谢雄激素类固醇的年轻健美运动员的左心室不同步和收缩后缩短

背景：在使用合成代谢雄激素 (AAS) 的力量训练运动员中观察到左心室 (LV) 重构，其特征是 LV 肥大和功能降低。先前的研究报告称，这些运动员的心脏纤维化增加，这可能会促进心室内不同步。在这种情况下，本研究评估了使用 AA 进行力量训练的运动员的 LV 不同步；假设 AAS 的使用导致 LV 不同步增加，收缩后缩短增加。方法：将 44 名参与者（年龄 20-40 岁）分为三个年龄匹配的组：使用 AAS 进行力量训练的运动员（用户，n=14）和未使用的（非用户，n=15），和健康久坐的男性（对照组，n=15）。完成调查后，每位参与者都接受了 2D 应变超声心动图评估。使用纵向应变 (SD)、纵向应变延迟指数 (LSDI) 和节段性收缩后指数 (PSI) 的峰值时间的标准偏差量化左心室不同步。结果：与对照组和非使用者相比，使用者表现出更高的 LV 质量指数和更高的收缩和舒张功能。使用者的 LV 应变减少主要在心室段观察到。SD、LSDI 和 PSI，根据基底下间隔、基底前间隔和基底下外侧段计算，在用户中较高。结论：结果强烈支持在年轻 AAS 用户中观察到的特定 LV 重塑与 LV 不同步的增加有关。与射血分数的相关性表明，由于收缩后缩短而浪费的能量，