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Authors
Abstract(s)
Introdução: Sendo competição e desporto ambos parte integrante das nossas culturas
desde os primórdios da humanidade, a necessidade de acompanhar a evolução dos tempos
e da ciência por parte dos atletas leva a que, por vezes, estes recorram a substâncias
exógenas de forma a aumentarem o seu rendimento desportivo. Esta busca por uma melhor
performance desportiva, associada à atual influência das redes sociais e dos media na
conceção da imagem das pessoas, levam a uma procura crescente destes produtos que
proporcionem resultados visíveis o mais rapidamente possível, não só por atletas
profissionais, mas também por desportistas amadores. Uma das substâncias mais usadas
atualmente neste contexto são os esteróides androgénicos anabólicos (anabolic androgenic
steroids). Assim, esta revisão bibliográfica tem como principal objetivo analisar as
principais consequências cardiovasculares causadas pela toma destas substâncias, e alertar
os consumidores das mesmas para os riscos a longo prazo aquando destes consumos.
Objetivos: Alertar a população geral, mas principalmente entidades reguladoras do
deporto, treinadores e inclusive médicos, para a globalização do doping; Sensibilizar para o
uso cada vez mais comum dos esteróides anabolizantes androgénicos, não só por atletas de
alta competição e bodybuilders, como também pelo simples frequentador de ginásio ou
desportista amador; Dar a conhecer, principalmente aos consumidores, os diversos efeitos
adversos do consumo de EAA, com especial enfoque num dos tipos de complicações mais
relatadas, as cardiovasculares; Abordar formas de prevenir e melhorar a deteção destes
consumos nos diversos contextos quer profissionais quer amadores, preferencialmente
antes das suas consequências se tornarem irreversíveis.
Metodologia: A presente dissertação foi realizada procedendo-se à pesquisa bibliográfica
de artigos científicos através das bases de dados PubMed, b-on, EBSCO HOST e ClinicalKey.
A seleção dos mesmos foi feita consoante a sua relevância para o tema em questão e foi dada
preferência àqueles publicados na última década. Ao longo desta leitura foram ainda
selecionados outros artigos e referências que constavam nestes.
Conclusão: Como foi possível comprovar pela bibliografia revista, a patologia
cardiovascular com associação aos EAA mais bem documentada é a hipertrofia cardíaca
(mais concretamente do ventrículo esquerdo) associada à disfunção cardíaca geral (sistólica
e diastólica, maioritariamente esquerda). Os casos de morte súbita por paragem cardíaca são também inúmeros, sendo que por vezes o mecanismo que origina esta paragem não é
descrito. As arritmias de diversos tipos (algumas fatais), os eventos resultantes do estado
de hipercoagulabidade/pro-trombótico induzido, e a fibrose cardíaca, têm todos algum
suporte bibliográfico e cada vez mais são relatados. A hipertensão arterial e as alterações no
metabolismo lipídico parecem ser eventos potencialmente mais curtos e reversíveis, sendo
que em consumos crónicos muito longos podem ter outra apresentação. Outras
consequências, nomeadamente a calcificação vascular e a cardiomiopatia dilatada, foram
também descritas, apesar de menos apoiadas pela literatura. Como podemos perceber,
apesar da literatura disponível nos dar já uma boa perceção das consequências
cardiovasculares do EAA, este tema continua em estudo e muitas das associações
mencionadas ainda necessitam de um melhor suporte científico.
Introduction: With competition and sports being an integral part of our cultures since the dawn of humanity, the need for athletes to keep up with the advances in science sometimes leads them to resort to exogenous substances in order to enhance their sports performance. This pursuit of better sports performance, coupled with the current influence of social platforms and the media in people's image conception, leads to a growing demand for products that provide visible results as quickly as possible, not only among professional athletes, but also among amateur sports enthusiasts. One of the most commonly used substances in this context are anabolic androgenic steroids. Therefore, this literature review aims to highlight the main cardiovascular consequences caused by taking these substances, and to alert consumers of the long-term risks associated with their use. Objectives: To raise awareness among the general population, especially among sports governing bodies, coaches, and even doctors, about the globalization of doping; Sensitize for the increasingly more common use of anabolic androgenic steroids, not only among elite athletes and bodybuilders, but also among gym members and amateur sports enthusiasts; To inform, especially the consumers, about the various adverse effects of anabolic androgenic steroids use, with special focus on one of the most reported types of complications - the cardiovascular ones; To address ways of preventing and improving the detection of such use in both professional and amateur contexts, preferably before the consequences become irreversible. Methodology: The present dissertation was elaborated by carrying out a bibliographic research of scientific articles through the PubMed, b-on, EBSCO HOST, and ClinicalKey databases. The selection of articles was based on their relevance to the topic in question, with preference given to those published in the last decade. Throughout this reading, other articles and references listed within them were also utilized. Conclusion: As it was possible to verify by the reviewed bibliography, the best documented cardiovascular pathology associated with anabolic androgenic steroids is cardiac hypertrophy (more specifically of the left ventricle) associated with global cardiac dysfunction (systolic and diastolic, mostly left). There are also several cases of sudden death due to cardiac arrest, and sometimes the mechanism that causes this arrest is not described. Arrhythmias of various types (some of them fatal), events resulting from the hypercoagulable/pro-thrombotic state induced, and cardiac fibrosis, all have some bibliographic support and are increasingly being reported. Arterial hypertension and changes in lipid metabolism seem to be potentially shorter and reversible events, however in very long chronic consumption they may have another clinical presentation. Other consequences, namely vascular calcification and dilated cardiomyopathy, have also been described, although less supported by the literature. As we can see, despite the available literature already giving us a good perception of anabolic androgenic steroids cardiovascular consequences, this topic is still under study and many of the associations mentioned are still in need of better scientific support.
Introduction: With competition and sports being an integral part of our cultures since the dawn of humanity, the need for athletes to keep up with the advances in science sometimes leads them to resort to exogenous substances in order to enhance their sports performance. This pursuit of better sports performance, coupled with the current influence of social platforms and the media in people's image conception, leads to a growing demand for products that provide visible results as quickly as possible, not only among professional athletes, but also among amateur sports enthusiasts. One of the most commonly used substances in this context are anabolic androgenic steroids. Therefore, this literature review aims to highlight the main cardiovascular consequences caused by taking these substances, and to alert consumers of the long-term risks associated with their use. Objectives: To raise awareness among the general population, especially among sports governing bodies, coaches, and even doctors, about the globalization of doping; Sensitize for the increasingly more common use of anabolic androgenic steroids, not only among elite athletes and bodybuilders, but also among gym members and amateur sports enthusiasts; To inform, especially the consumers, about the various adverse effects of anabolic androgenic steroids use, with special focus on one of the most reported types of complications - the cardiovascular ones; To address ways of preventing and improving the detection of such use in both professional and amateur contexts, preferably before the consequences become irreversible. Methodology: The present dissertation was elaborated by carrying out a bibliographic research of scientific articles through the PubMed, b-on, EBSCO HOST, and ClinicalKey databases. The selection of articles was based on their relevance to the topic in question, with preference given to those published in the last decade. Throughout this reading, other articles and references listed within them were also utilized. Conclusion: As it was possible to verify by the reviewed bibliography, the best documented cardiovascular pathology associated with anabolic androgenic steroids is cardiac hypertrophy (more specifically of the left ventricle) associated with global cardiac dysfunction (systolic and diastolic, mostly left). There are also several cases of sudden death due to cardiac arrest, and sometimes the mechanism that causes this arrest is not described. Arrhythmias of various types (some of them fatal), events resulting from the hypercoagulable/pro-thrombotic state induced, and cardiac fibrosis, all have some bibliographic support and are increasingly being reported. Arterial hypertension and changes in lipid metabolism seem to be potentially shorter and reversible events, however in very long chronic consumption they may have another clinical presentation. Other consequences, namely vascular calcification and dilated cardiomyopathy, have also been described, although less supported by the literature. As we can see, despite the available literature already giving us a good perception of anabolic androgenic steroids cardiovascular consequences, this topic is still under study and many of the associations mentioned are still in need of better scientific support.
Description
Keywords
Desporto Doenças Cardiovasculares Doping Esteróides Anabolizantes Androgénicos Testosterona