A 60-year-old man was found dead at home by his wife. The man was known to be a regular trainer in a fitness center and was described as a long-term user of anabolic steroids. The autopsy revealed heart failure with cardiomegaly, visceral congestion, and pulmonary edema. The local prosecutor ordered toxicological analyses but no anatomic pathology test. Initial analyses by the liquid chromatography coupled to quadrupole time-of-flight mass spectrometry system (UPLC-q-TOF-MS) system indicated the presence in femoral blood of trenbolone, an anabolic steroid. Trenbolone was quantified with a liquid chromatography system coupled with a tandem mass spectrometer in various autopsy specimens, including hair. Concentrations of trenbolone were 3.9, 3.2, 231, and lower than 0.5 ng/mL in femoral blood, cardiac blood, bile, and vitreous humor, respectively. Moreover, in head hair, the concentration was 9 pg/mg. The presence of trenbolone in hair can be interpreted as repetitive exposures when compared to the limited literature data. Repetitive misuse of trenbolone can explain advanced heart failure. This paper highlights the importance of testing biological specimens for anabolic steroids in case of heart failure.

中文翻译：

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在尸检病例的生物体液和头发中检测群勃龙（一种合成代谢类固醇）


一名60岁男子被妻子发现在家中死亡。据了解，这名男子是一家健身中心的定期教练，并被描述为长期服用合成代谢类固醇的人。尸检显示心力衰竭、心脏扩大、内脏充血和肺水肿。当地检察官下令进行毒理学分析，但没有进行解剖病理学测试。液相色谱与四极杆飞行时间质谱系统 (UPLC-q-TOF-MS) 系统的初步分析表明，股骨血液中存在群勃龙（一种合成代谢类固醇）。使用液相色谱系统和串联质谱仪对各种尸检标本（包括头发）中的群勃龙进行定量。股血、心脏血、胆汁和玻璃体液中群勃龙的浓度分别为 3.9、3.2、231 和低于 0.5 ng/mL。另外，头发中的浓度为9pg/m​​g。与有限的文献数据相比，头发中群勃龙的存在可以解释为重复暴露。反复滥用群勃龙可以解释晚期心力衰竭。本文强调了在心力衰竭的情况下测试生物样本中合成代谢类固醇的重要性。