Steroids – ABC CARDIOL

IJCS

Editorial

Anabolic-Androgenic Steroids and Cardiotoxicity

José Antônio Caldas Teixeira et al. Joelma Dominato Rocha Carvalho Mateus Freitas Teixeira

Anabolic-androgenic steroids (AAS) are a class of natural and synthetic hormones, which owe their name to their chemical structure (steroid nucleus) and their biological, anabolic, and androgenic effects. Misuse of AAS for aesthetic and performance purposes has become widespread, as they provide increases in muscle mass and strength. It is estimated that approximately 3.5% of the world’s population uses AAS.

Use of AAS dates back to ancient Greece, followed by the Second World War. They were detected in sports competitions in 1954 and later disseminated among bodybuilders and identified in various sports in the Tokyo 1964 Olympic Games. Currently, we are witnessing a growing encouragement of AAS use for aesthetic purposes, through “beauty chips” and disguised as hormone replacement therapy. This indiscriminate use culminated in a resolution by the Brazilian Federal Council of Medicine against the prescription of these hormones for aesthetic purposes.

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ABCIC

Review Article

The Indiscriminate Use Of Androgenic Anabolic Steroids: The Contribution of Cardiovascular Imaging

Irving Gabriel Araöşjo Bispo et al. Isabella Montanher Zago

Abstract

Anabolic androgenic steroids (AAS) are natural or synthetic compounds similar to the male hormone testosterone. The literature also describes cases of AAS abuse, such as in bodybuilding, cosmetics, recreational use, and aesthetic enhancement. It was discovered that AAS alone directly induce myocardial injury, with the main pathological finding in autopsied hearts being left ventricle (LV) hypertrophy in frequent association with myocyte hypertrophy, increased collagen deposition in the matrix, increased activity of the cardiac angiotensin, and myocardial fibrosis.

Patients who used illicit AAS present decreased LV systolic function. In athletes who self-administer AAS, LV hypertrophy and elevated sympathetic modulation were observed, as well as elevated blood pressure (BP). High doses of AAS can cause the user to have ventricular arrhythmias and sudden death. Furthermore, AAS users demonstrated greater coronary artery plaque volume than non-users. The objective of this review is to revisit the main effects of the use of AAS on cardiac changes through cardiovascular imaging as well as to establish a difference in relation to athletic heart syndrome.

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IJCS

Case Report

Fulminant Necrotizing Eosinophilic Myocarditis Successfully Treated With Veno-Arterial Extracorporeal Membrane Oxygenation and High-Dose Steroids

Tamara Pereira et al. Mariana Tinoco Bebiana Faria Olga Azevedo … Roberto Roncon Albuquerque António Lourenço

Abstract

Fulminant necrotizing eosinophilic myocarditis (FNEM) is a rare form of EM characterized by biventricular heart failure with hemodynamic deterioration, often requiring inotropes or mechanical circulatory support. Here, we report a case of a 43-year-old healthy woman with FNEM who was admitted with acute heart failure that rapidly progressed to cardiogenic shock and electrical storm, culminating in cardiac arrest. Early diagnosis and prompt administration of corticosteroids in combination with veno-arterial extracorporeal membrane oxygenation allowed complete recovery of biventricular systolic function.

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ABC

Letter to the Editor

The Need for Sex Hormone Analysis in Addition to Long-Term Follow-Up of Phytosterol Supplementation

Heitor Oliveira Santos

Dear Editor,

I read with great interest the article entitled “Phytosterols in the Treatment of Hypercholesterolemia and Prevention of Cardiovascular Diseases”, by Cabral and Klein, published in the Brazilian Archives of Cardiology. The authors discuss phytosterol doses in the treatment of hypercholesterolemia, showing the current consensus of renowned guidelines and approval by global regulatory agencies.

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ABC

Artigo Original

Electrocardiographic profile and muscle glycogen content of rats treated with nandrolone

Carlos Alberto da Silva et al. Adriano Cesar Rocco Pardi Talita Moral Gonçalves Sergio Henrique Borin

BACKGROUND: We considered both the indiscriminate use of steroids by top athletes and by physically active individuals. OBJECTIVE: To evaluate the effects of nandrolone decanoate on the electrocardiographic profile, glycogen content and total-protein profile of skeletal and cardiac muscles, as well as the plasma albumin concentrations. METHODS: The drug was administered subcutaneously, at a concentration of 5 mg/kg, twice a week for three weeks, to animals in the treated group. Once a week, the rats were anesthetized with sodium pentobarbital (50 mg/kg, ip) and they underwent an electrocardiogram (ECG). After the trial period, samples of the cardiac muscle (left ventricle – LV), soleus muscle (S), white gastrocnemius muscle (WG), red gastrocnemius muscle (RG), pectoral muscle (P), intercostal muscle (IC) and diaphragm muscle (D) were promptly collected and analyzed. An analysis of variance (ANOVA) and then a Tukey test (p>0.05) were carried out to assess the data (mean ± sem). RESULTS: There were changes in the following parameters of rats in the treated group: QRS interval, QTc interval and heart rate, characterized by an increase in these parameters, with the peak being reached in the period between the pre-treatment week and the first week. There was an increase of 127% in glycogen reserves in the LV. In relation to the total-protein amount, the significant difference was found in S, RG and D. As for the hematocrit and biochemical profile, it was possible to notice an increase in the percentage of erythrocytes. CONCLUSION: The study shows that major cardiac changes are triggered at an early stage, which indicates a hierarchy in the sequence of changes that compromise the homeostasis of the body.

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Anabolic-Androgenic Steroids and Cardiotoxicity

The Indiscriminate Use Of Androgenic Anabolic Steroids: The Contribution of Cardiovascular Imaging

Abstract

Fulminant Necrotizing Eosinophilic Myocarditis Successfully Treated With Veno-Arterial Extracorporeal Membrane Oxygenation and High-Dose Steroids

Abstract

The Need for Sex Hormone Analysis in Addition to Long-Term Follow-Up of Phytosterol Supplementation

Electrocardiographic profile and muscle glycogen content of rats treated with nandrolone

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