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1.
Clinics (Sao Paulo) ; 73: e226, 2018 05 21.
Article in English | MEDLINE | ID: mdl-29791601

ABSTRACT

OBJECTIVES: Misuse of anabolic androgenic steroids in athletes is a strategy used to enhance strength and skeletal muscle hypertrophy. However, its abuse leads to an imbalance in muscle sympathetic nerve activity, increased vascular resistance, and increased blood pressure. However, the mechanisms underlying these alterations are still unknown. Therefore, we tested whether anabolic androgenic steroids could impair resting baroreflex sensitivity and cardiac sympathovagal control. In addition, we evaluate pulse wave velocity to ascertain the arterial stiffness of large vessels. METHODS: Fourteen male anabolic androgenic steroid users and 12 nonusers were studied. Heart rate, blood pressure, and respiratory rate were recorded. Baroreflex sensitivity was estimated by the sequence method, and cardiac autonomic control by analysis of the R-R interval. Pulse wave velocity was measured using a noninvasive automatic device. RESULTS: Mean spontaneous baroreflex sensitivity, baroreflex sensitivity to activation of the baroreceptors, and baroreflex sensitivity to deactivation of the baroreceptors were significantly lower in users than in nonusers. In the spectral analysis of heart rate variability, high frequency activity was lower, while low frequency activity was higher in users than in nonusers. Moreover, the sympathovagal balance was higher in users. Users showed higher pulse wave velocity than nonusers showing arterial stiffness of large vessels. Single linear regression analysis showed significant correlations between mean blood pressure and baroreflex sensitivity and pulse wave velocity. CONCLUSIONS: Our results provide evidence for lower baroreflex sensitivity and sympathovagal imbalance in anabolic androgenic steroid users. Moreover, anabolic androgenic steroid users showed arterial stiffness. Together, these alterations might be the mechanisms triggering the increased blood pressure in this population.


Subject(s)
Anabolic Agents/adverse effects , Androgens/adverse effects , Autonomic Nervous System/drug effects , Baroreflex/drug effects , Cardiovascular System/drug effects , Vagus Nerve/drug effects , Adult , Autonomic Nervous System/physiology , Baroreflex/physiology , Blood Pressure/drug effects , Cardiovascular Physiological Phenomena/drug effects , Cross-Sectional Studies , Heart Rate/drug effects , Humans , Male , Muscle Strength/drug effects , Muscle Stretching Exercises , Pulse Wave Analysis , Respiratory Rate/drug effects , Risk Factors , Statistics, Nonparametric , Vagus Nerve/physiology , Vascular Stiffness/drug effects
2.
Clinics ; 73: e226, 2018. tab
Article in English | LILACS | ID: biblio-890749

ABSTRACT

OBJECTIVES: Misuse of anabolic androgenic steroids in athletes is a strategy used to enhance strength and skeletal muscle hypertrophy. However, its abuse leads to an imbalance in muscle sympathetic nerve activity, increased vascular resistance, and increased blood pressure. However, the mechanisms underlying these alterations are still unknown. Therefore, we tested whether anabolic androgenic steroids could impair resting baroreflex sensitivity and cardiac sympathovagal control. In addition, we evaluate pulse wave velocity to ascertain the arterial stiffness of large vessels. METHODS: Fourteen male anabolic androgenic steroid users and 12 nonusers were studied. Heart rate, blood pressure, and respiratory rate were recorded. Baroreflex sensitivity was estimated by the sequence method, and cardiac autonomic control by analysis of the R-R interval. Pulse wave velocity was measured using a noninvasive automatic device. RESULTS: Mean spontaneous baroreflex sensitivity, baroreflex sensitivity to activation of the baroreceptors, and baroreflex sensitivity to deactivation of the baroreceptors were significantly lower in users than in nonusers. In the spectral analysis of heart rate variability, high frequency activity was lower, while low frequency activity was higher in users than in nonusers. Moreover, the sympathovagal balance was higher in users. Users showed higher pulse wave velocity than nonusers showing arterial stiffness of large vessels. Single linear regression analysis showed significant correlations between mean blood pressure and baroreflex sensitivity and pulse wave velocity. CONCLUSIONS: Our results provide evidence for lower baroreflex sensitivity and sympathovagal imbalance in anabolic androgenic steroid users. Moreover, anabolic androgenic steroid users showed arterial stiffness. Together, these alterations might be the mechanisms triggering the increased blood pressure in this population.


Subject(s)
Humans , Male , Adult , Autonomic Nervous System/drug effects , Vagus Nerve/drug effects , Cardiovascular System/drug effects , Baroreflex/drug effects , Anabolic Agents/adverse effects , Androgens/adverse effects , Autonomic Nervous System/physiology , Blood Pressure/drug effects , Cardiovascular Physiological Phenomena/drug effects , Cross-Sectional Studies , Risk Factors , Baroreflex/physiology , Vascular Stiffness/drug effects , Pulse Wave Analysis
3.
Mayo Clin Proc ; 91(5): 575-86, 2016 May.
Article in English | MEDLINE | ID: mdl-27040087

ABSTRACT

OBJECTIVE: To examine whether combined testosterone replacement and exercise training (ET) therapies would potentiate the beneficial effects of isolated therapies on neurovascular control and muscle wasting in patients with heart failure (HF) with testosterone deficiency. PATIENTS AND METHODS: From January 10, 2010, through July 25, 2013, 39 male patients with HF, New York Heart Association functional class III, total testosterone level less than 249 ng/dL (to convert to nmol/L, multiply by .03467), and free testosterone level less than 131 pmol/L were randomized to training (4-month cycloergometer training), testosterone (intramuscular injection of testosterone undecylate for 4 months), and training + testosterone groups. Muscle sympathetic nerve activity was measured using microneurography, forearm blood flow using plethysmography, body composition using dual X-ray absorptiometry, and functional capacity using cardiopulmonary test. Skeletal muscle biopsy was performed in the vastus lateralis. RESULTS: Muscle sympathetic nerve activity decreased in ET groups (training, P<.01; training + testosterone, P<.01), whereas no changes were observed in the testosterone group (P=.89). Forearm blood flow was similar in all groups. Lean mass increased in ET groups (training, P<.01; training + testosterone, P<.01), whereas lean mass decreased in the testosterone group (P<.01). The response of cross-sectional area of type I (P<.01) and type II (P<.05) fibers increased in the training + testosterone group as compared with the isolated testosterone group. CONCLUSION: Our findings provide evidence for a superior effect of combined ET and testosterone replacement therapies on muscle sympathetic nerve activity, muscle wasting, and functional capacity in patients with HF with testosterone deficiency.


Subject(s)
Exercise/physiology , Heart Failure/therapy , Hormone Replacement Therapy , Muscle, Skeletal/drug effects , Testosterone/administration & dosage , Absorptiometry, Photon , Analysis of Variance , Androgens/administration & dosage , Androgens/deficiency , Androgens/physiology , Biopsy , Body Composition , Brazil , Combined Modality Therapy , Exercise Test , Forearm/blood supply , Heart Failure/blood , Heart Failure/complications , Humans , Injections, Intramuscular , Male , Middle Aged , Muscle, Skeletal/pathology , Muscle, Skeletal/physiopathology , Oxygen Consumption , Plethysmography , Prognosis , Prospective Studies , Quadriceps Muscle/metabolism , Quadriceps Muscle/pathology , Quality of Life , Sympathetic Nervous System/physiopathology , Testosterone/deficiency , Testosterone/physiology
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