P6123Impaired left ventricular systolic function among androgen abusers is associated with increased arterial afterload

Abstract

Background: It is incompletely understood if adverse effects of androgen abuse (AA) on left ventricular (LV) mass and systolic function are direct or mediated by increased arterial afterload as AA is associated with hypertension. Purpose: To investigate LV mass and systolic function in relation to plasma free testosterone and arterial elastance (Ea), an indicator of arterial afterload, among current and former AAs compared with controls. Methods: Cross-sectional study among men involved in recreational resistance training. We assessed LV mass by 2-D echocardiography. LV function was evaluated using ejection fraction (LVEF, Simpson's biplane) and global longitudinal strain (GLS, speckle-tracking). We measured blood pressure (BP) using 24-hour ambulatory monitoring, assessed body composition by dual-energy x-ray absorptiometry and obtained overnight fasting blood samples. Ea = (0.9 x systolic BP) /stroke volume. Results: We included 30 controls, 37 current and 33 former AAs. LVEF was decreased and LV mass index increased among current AAs compared with the other two groups (Table). LV GLS was impaired and Ea was increased among both current and former AAs compared with controls. High Ea was independently associated with impaired LV GLS after adjustment for age and free testosterone (log2) in a multivariate linear regression model; (B) (95% CI), (2.5 (1.2; 3.8), P<0.01). In contrast, high levels of free testosterone was independently associated with increased LV mass index (0.17 (0.03; 0.30), P=0.01). Conclusions: Current and, notably, former AAs exhibited decreased LV systolic function which was strongly associated with increased arterial afterload. In contrast, increased LV mass among current AAs could be mediated directly by supraphysiologic plasma levels of androgens.