{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:19Z","timestamp":1790586019962,"version":"4.1.0"},"reference-count":74,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Nonmedical anabolic\u2010androgenic steroid (AAS) use is increasing, and its duration\u2010dependent cardiac effects remain unclear. We evaluated cardiac structure and function in AAS\u2010using strength\u2010trained athletes, overall and by exposure duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Cochrane Central, and SCOPUS through November 2025 for observational studies comparing AAS\u2010using and nonusing strength\u2010trained athletes of either sex. Random\u2010effects models pooled mean differences (MD) overall and across four exposure strata (&lt;6 months, 6 months\u20133 years, 3\u20136 years, &gt;6 years); meta\u2010regression assessed duration as a continuous moderator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty studies (1906 athletes; 95% male) were included. Overall, AAS users showed reduced left ventricular ejection fraction (LVEF; 29 studies; MD \u22122.84%; 95% CI \u22124.24 to \u22121.44;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01), impaired global longitudinal strain (GLS; MD +3.27%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01), and increased left ventricular mass index (LVMI; MD +18.21\u00a0g\/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). Septal thickening was detectable before six months, preceding functional impairment. LVEF, LVMI, and posterior wall thickness (PWT) differed significantly across strata (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2264\u00a00.03), with the largest LVEF reduction beyond six years (MD \u22127.39%; 95% CI \u221210.71 to \u22124.07). Meta\u2010regression suggested that exposure duration was associated with variation in selected structural and functional outcomes, corroborating LVEF, LVMI, and PWT, while GLS, E\/e\u2032, and E\/A ratio showed no significant association. Right ventricular strain was impaired in an exploratory, non\u2010stratified analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AAS use is associated with cardiac structural and functional abnormalities, with exposure duration associated with selected, but not all, outcomes. These cross\u2010sectional comparisons do not establish within\u2010person progression; longitudinal surveillance with deformation imaging is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70611","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:36:05Z","timestamp":1788197765000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Duration\u2010Dependent Cardiac Effects of Anabolic\u2010Androgenic Steroid Use in Strength\u2010Trained Athletes: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6536-0862","authenticated-orcid":false,"given":"Matheus de Medeiros","family":"Fernandes","sequence":"first","affiliation":[{"name":"Medicine Department State University of Rio Grande Do Norte (UERN)  Mossor\u00f3 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