Duration-Dependent Cardiac Effects of Anabolic-Androgenic Steroid Use in Strength-Trained Athletes: A Systematic Review and Meta-Analysis.
MM, F., PG, B., CVR, C., RRADS, S., FM, S., MC, L., FM, F., RS, P., PJ, d.F., & FHAP, V. (2026). Duration-Dependent Cardiac Effects of Anabolic-Androgenic Steroid Use in Strength-Trained Athletes: A Systematic Review and Meta-Analysis.. Echocardiography (Mount Kisco, N.Y.). https://doi.org/10.1111/echo.70611
MM F, PG B, CVR C, RRADS S, FM S, MC L, et al. Duration-Dependent Cardiac Effects of Anabolic-Androgenic Steroid Use in Strength-Trained Athletes: A Systematic Review and Meta-Analysis.. Echocardiography (Mount Kisco, N.Y.). 2026; doi: 10.1111/echo.70611
MM F, PG B, CVR C, et al. Duration-Dependent Cardiac Effects of Anabolic-Androgenic Steroid Use in Strength-Trained Athletes: A Systematic Review and Meta-Analysis.[J]. Echocardiography (Mount Kisco, N.Y.). 2026. DOI: 10.1111/echo.70611.
@article{mm2026,
author = {Fernandes MM and Batista PG and Chagas CVR and Silva RRADS and Santos FM and Lenzi MC and Fernandes FM and Pessoa RS and de Freitas PJ and Véras FHAP},
title = {Duration-Dependent Cardiac Effects of Anabolic-Androgenic Steroid Use in Strength-Trained Athletes: A Systematic Review and Meta-Analysis.},
journal = {Echocardiography (Mount Kisco, N.Y.)},
year = {2026},
doi = {10.1111/echo.70611},
note = {PMID: 42672095},
}
TY - JOUR AU - Fernandes MM AU - Batista PG AU - Chagas CVR AU - Silva RRADS AU - Santos FM AU - Lenzi MC AU - Fernandes FM AU - Pessoa RS AU - de Freitas PJ AU - Véras FHAP TI - Duration-Dependent Cardiac Effects of Anabolic-Androgenic Steroid Use in Strength-Trained Athletes: A Systematic Review and Meta-Analysis. T2 - Echocardiography (Mount Kisco, N.Y.) PY - 2026 DO - 10.1111/echo.70611 AN - PMID:42672095 ER -
PURPOSE: Nonmedical anabolic-androgenic steroid (AAS) use is increasing, and its duration-dependent cardiac effects remain unclear. We evaluated cardiac structure and function in AAS-using strength-trained athletes, overall and by exposure duration. METHODS: We searched PubMed, Embase, Cochrane Central, and SCOPUS through November 2025 for observational studies comparing AAS-using and nonusing strength-trained athletes of either sex. Random-effects models pooled mean differences (MD) overall and across four exposure strata (<6 months, 6 months-3 years, 3-6 years, >6 years); meta-regression assessed duration as a continuous moderator. RESULTS: Forty studies (1906 athletes; 95% male) were included. Overall, AAS users showed reduced left ventricular ejection fraction (LVEF; 29 studies; MD -2.84%; 95% CI -4.24 to -1.44; p < 0.01), impaired global longitudinal strain (GLS; MD +3.27%; p < 0.01), and increased left ventricular mass index (LVMI; MD +18.21 g/m2; p < 0.01). Septal thickening was detectable before six months, preceding functional impairment. LVEF, LVMI, and posterior wall thickness (PWT) differed significantly across strata (all p ≤ 0.03), with the largest LVEF reduction beyond six years (MD -7.39%; 95% CI -10.71 to -4.07). Meta-regression suggested that exposure duration was associated with variation in selected structural and functional outcomes, corroborating LVEF, LVMI, and PWT, while GLS, E/e', and E/A ratio showed no significant association. Right ventricular strain was impaired in an exploratory, non-stratified analysis. CONCLUSION: AAS use is associated with cardiac structural and functional abnormalities, with exposure duration associated with selected, but not all, outcomes. These cross-sectional comparisons do not establish within-person progression; longitudinal surveillance with deformation imaging is warranted.