AIMS The real effects of the chronic consumption of anabolic-androgenic steroids (AASs) on cardiovascular structures are subjects of intense debate. The aim of the study was to detect by speckle tracking echocardiography (STE) right ventricular (RV) and left ventricular (LV) dysfunction at rest and during exercise stress echocardiography (ESE) in athletes abusing AAS. METHODS AND RESULTS One hundred and fifteen top-level competitive bodybuilders were selected (70 males), including 65 athletes misusing AAS for at least 5 years (users), 50 anabolic-free bodybuilders (non-users), compared to 50 age- and sex-matched healthy sedentary controls. Standard Doppler echocardiography, STE analysis, and lung ultrasound at rest and at peak supine-bicycle ESE were performed. Athletes showed increased LV mass index, wall thickness, and RV diameters compared with controls, whereas LV ejection fraction was comparable within the groups. left atrial volume index, LV and RV strain, and LV E/Em were significantly higher in AAS users. Users showed more B-lines during stress (median 4.4 vs. 1.25 in controls and 1.3 in non-users, P < 0.01 vs. users). By multivariable analyses, LV E/Ea (beta coefficient = 0.35, P < 0.01), pulmonary artery systolic pressure (beta = 0.43, P < 0.001) at peak effort and number of weeks of AAS use per year (beta = 0.45, P < 0.001) emerged as the only independent determinants of resting RV lateral wall peak systolic two-dimensional strain. In addition, a close association between resting RV myocardial function and VO2 peak during ESE was evidenced (P < 0.001), with a powerful incremental value with respect to clinical and standard echocardiographic data. CONCLUSIONS In athletes abusing steroids, STE analysis showed an impaired RV systolic deformation, closely associated with reduced functional capacity during physical effort, and-during exercise-more pulmonary congestion.

中文翻译：

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合成代谢雄激素类固醇运动员的双心室功能障碍和肺充血：斑点追踪和压力肺超声心动图分析。

目的 长期服用合成代谢雄激素类固醇 (AAS) 对心血管结构的真正影响是激烈争论的主题。该研究的目的是通过斑点追踪超声心动图 (STE) 检测滥用 AAS 的运动员在休息和运动负荷超声心动图 (ESE) 时的右心室 (RV) 和左心室 (LV) 功能障碍。方法和结果 选择了 115 名顶级竞技健美运动员（70 名男性），其中包括 65 名滥用 AAS 至少 5 年的运动员（用户），50 名无合成代谢的健美运动员（非用户），相比之下，年龄和年龄分别为 50 名和性别匹配的健康久坐控制。进行了标准多普勒超声心动图、STE 分析以及静息和仰卧自行车 ESE 峰值时的肺超声。运动员表现出左室质量指数、壁厚、和 RV 直径与对照组相比，而 LV 射血分数在组内具有可比性。AAS 用户的左心房容积指数、LV 和 RV 应变以及 LV E/Em 显着较高。用户在压力期间表现出更多的 B 线（对照组中位数为 4.4 对 1.25，非用户中位数为 1.3，P < 0.01 对用户）。通过多变量分析，峰值努力时的 LV E/Ea（β 系数 = 0.35，P < 0.01）、肺动脉收缩压（β = 0.43，P < 0.001）和每年使用 AAS 的周数（β = 0.45，P < 0.001) 成为静息 RV 侧壁峰值收缩二维应变的唯一独立决定因素。此外，静息 RV 心肌功能与 ESE 期间的 VO2 峰值密切相关（P < 0.001），在临床和标准超声心动图数据方面具有强大的增量价值。结论 在滥用类固醇的运动员中，STE 分析显示右室收缩变形受损，与体力活动期间功能能力下降密切相关，并且在运动期间肺充血更多。