Resumo

Este artigo tem o objetivo de discutir os efeitos colaterais do uso recreativo do esteroide anabólico androgênico Decanoato de Nandrolona no sistema cardiovascular, abordando os mecanismos responsáveis por alterações estruturais, funcionais e moleculares promovidas pelo uso não terapêutico deste composto, e contribuir para o esclarecimento de jovens praticantes de atividades físicas, de atletas, e de estudantes de educação física sobre os graves problemas promovidos no organismo pelo abuso de esteroides anabólicos androgênicos.

Referências

ABRAHIN, O.S., SOUSA, E.C., SANTOS, A.M. Prevalence of the use of anabolic-androgenic steroids in Brazil: a systematic review. Substance Use & Misuse, 49(9):1156-62, 2014.

ABRAHIN, O.S., SOUZA, N.S.F., SOUSA, E.C., MOREIRA, J.K.R., NASCIMENTO, V.C. Prevalence of the use of anabolic androgenis steroids by physical education students and teachers who work in health clubs. Revista Brasileira de Medicina do Esporte, 19(1):27-30, 2013.

AKÇAKOYUN, M., ALIZADE, E., GÜNDOĞDU, R., BULUT, M., TABAKCI, M.M., AÇAR, G., AVCI, A., SIMŞEK, Z., FIDAN, S., DEMIR, S., KARGIN, R., EMIROĞLU, M.Y. Long-term anabolic androgenic steroid use is associated with increased atrial electromechanical delay in male bodybuilders. Biomed Research International. 2014:1-8, ID451520, 2014.

BEUTEL, A., BERGAMASCHI, C.T., CAMPOS, R.R. Effects of chronic anabolic steroid treatment on tonic and reflex cardiovascular control in male rats. The Journal of Steroid Biochemistry and Molecular Biology, 93(1):43-82, 2005.

BINAYI, F., JOUKAR, S., NAJAFIPOUR, H., KARIMI, A., ABDOLLAHI, F., MASUMI, Y. The Effects of Nandrolone Decanoate Along with Prolonged Low-Intensity Exercise on Susceptibility to Ventricular Arrhythmias. Cardiovascular Toxicology. doi:10.1007/s12012-015-9313-3, 2015.

BRUDER-NASCIMENTO, T., CORDELLINI, S. Vascular adaptive responses to physical exercise and to stress are affected differently by nandrolone administration. Brazilian Journal of Medical and Biological Research, 44(4):337-44, 2011.

BRUM, P.C., FORJAZ, C.L.M., TINUCCI, T., NEGRÃO, C.E. Adaptações agudas e crônicas do exercício físico no sistema cardiovascular. Revista Paulista de Educação Física. 18:21-31, 2004.

CELOTTI, F., NEGRI, CESI P. Anabolic steroids: a review of their effects on the muscles, of their possible mechanisms of action and of their use in athletics. The Journal of Steroid Biochemistry and Molecular Biology, 43(5):469-77, 1992.

CHAVES, E.A., PEREIRA-JÚNIOR, P.P., FORTUNATO, R.S., MASUDA, M.O., DE CARVALHO, A.C., DE CARVALHO, D.P., Oliveira, M.F., Nascimento, J.H. Nandrolone decanoate impairs exercise-induced cardioprotection: role of antioxidant enzymes. The Journal of Steroid Biochemistry and Molecular Biology, 99(4-5): 223-30, 2006.

CHIEN, K.R., KNOWLTON, K.U., ZHU, H., CHIEN, S. Regulation of cardiac gene expression during myocardial growth and hypertrophy: molecular studies of an adaptive physiologic response. FASEB. 5(15): 3037-46, 1991.

CLARK, B.M., SCHOFIELS, R.S. Dilated cardiomyopathy and acute liver injury associated with combined use of ephedra, gamma-hydroxybutyrate, and anabolic steroids. Pharmacotherapy, 25(5): 756-61, 2005.

CONRAD, C.H., BROOKS, W.W., ROBINSON, K.G., BING, O.H.L. Impaired myocardial function in spontaneously hypertensive rats with heart failure. The American Journal of Physiology, 260(1): H136-45, 1991.

CREUTZBERG, E.C., SCHOLS, A.M. Anabolic Steroids. Current Opinion in Clinical Nutrition and Metabolic Care, 2(3): 243-53, 1999.

CUNHA, T.S., CUNHA, N.S., MOURA, M.J.C.S., MARCONDES, F.K. Esteroides anabólicos androgênicos e sua relação com a prática desportiva. Revista Brasileira de Ciências Farmacêuticas, 40(2): 165-179, 2004.

CUNHA, T.S., MOURA, M.J.C.S., BERNARDES, C.F., TANNO, A.P., MARCONDES, F.K. Vascular sensitivity to phenylefrine in rats submitted to anaerobic training and nandrolone treatment. Hypertension, 46:1-6, 2005.

DO CARMO, E.C., FERNANDES, T., KOIKE, D., DA SILVA, N.D. JR., MATTOS, K.C., ROSA, K.T., BARRETTI, D., MELO, S.F., WICHI, R.B., IRIGOYEN, M.C., DE OLIVEIRA, E.M. Anabolic steroid associated to physical training induces deleterious cardiac effects. Medicine Science in Sports and Exercise, 43(10):1836-48, 2011.

DRIESEN, R.B., VERHEYEN, F.K., DEBIE, W., BLAAUW, E., BABIKER, F.A., CORNELUSSEN, R.N.M., et al. Re-expression of alpha skeletal actin as a marker for dedifferentiation in cardiac pathologies. Journal of Cellular and Molecular Medicine, 13(5):896-908, 2009.

EBENBICHLER, C.F., STURM, W., GÄNZER, H., BODNER, J., MANGWETH, B., RITSCH, A., SANDHOFER, A., LECHLEITNER, M., FÖGER, B., PATSCH, J.R. Flow-mediated, endothelium-dependent vasodilatation is impaired in male body builders taking anabolic-androgenic steroids. Atherosclerosis, 158(2):483-90, 2001.

FERNANDES, T., SOCI, U.P., OLIVEIRA, E.M. Eccentric and concentric cardiac hypertrophy induced by exercise training: microRNAs and molecular determinants. Brazilian Journal of Medical and Biological Research, 44(9):836-47, 2011.

FINESCHI, V., RIEZZO, I., CENTINI, F., SILINGARDI, E., LICATA, M., BEDUSCHI, G., KARCH, S.B. Sudden cardiac death during anabolic steroid abuse: morphologic and toxicologic findings in two fatal cases of bodybuilders. International Journal of Legal Medicine, 121(1):48-53, 2007.

FRANCHINI, K.G. Hipertrofia cardíaca: mecanismos moleculares. Revista Brasileira de Hipertensão, 8:125-42, 2001.

FRANKENFELD, S.P., OLIVEIRA, L.P., ORTENZI, V.H., REGO-MONTEIRO, I.C., CHAVES, E.A., FERREIRA, A.C., LEITÃO, A.C., CARVALHO, D.P., FORTUNATO, R.S. The anabolic androgenic steroid nandrolone decanoate disrupts redox homeostasis in liver, heart and kidney of male Wistar rats. PLoS One, 9(9):e102699, 2014.

FRATI, P., BUSARDÒ, F.P., CIPOLLONI, L., DOMINICIS, E.D., FINESCHI, V. Anabolic Androgenic Steroid (AAS) Related Deaths: Autoptic, Histopathological and Toxicological Findings. Current Neuropharmacology, 13(1):146-59, 2015.

GARCIA, J.A.D., INCERPI, E.K. Fatores e Mecanismos Envolvidos na Hipertrofia Ventricular Esquerda e o Papel Anti-Hipertrófico do Óxido Nítrico. Arquivos Brasileiros de Cardiologia, 90(6): 443-450, 2008.

GELFAND, M.M., WITA, B. Androgen and estrogen-androgen hormone replacement therapy: a review of the safety literature. Clinical Therapeutics, 19(3): 383-404, 1997.

GROGAN, S., SHEPHERD, S., EVANS, R., WRIGHT, S., HUNTER, G. Experiences of anabolic steroids use: In-depth interviews with men and woman bodybuilders. Journal of Health Psycology, 11(6):845-56, 2006.

GRUBER, A.J., POPE, J.H.G. Psychiatric and medical effects of anabolic-androgenic steroid use in women. Psychotherapy and Psychosomatics, 69(1): 19-26, 2000.

HART, G. Exercise-induced cardiac hypertrophy: a substrate for sudden death in athletes? Experimental Physiology, 88(5):639-44, 2003.

ILHAN, E., DEMIRCI, D., GÜVENÇ, T.S., CALIK, A.N. Acute myocardial infarction and renal infarction in a bodybuilder using anabolic steroids. Turk Kardiyoloji Dernegi Arsivi, 38(4):275-8, 2010.

IZUMO, S., NADAL-GINARD, B., MAHDAVI, V. Protooncogene induction and reprogramming of cardiac gene expression produced by pressure overload. Proceedings of the National Academy of Sciences of the United States of America, 85(2):339-43, 1988.

KALMANOVICH, E., MINHA, S., LEITMAN, M., VERED, Z., BLATT, A. Androgenic-anabolic steroid (Boldenone) abuse as a cause of dilated cardiovyopathy. Journal of General Practice, 2(3): 153, 2014.

KRIEGER, J.K. Hipertensão arterial e hipertrofia cardíaca. Revista da Sociedade de Cardiologia do Estado de São Paulo, 5: 3, 1995.

KUHN, C.M. Anabolic steroids. Recent Progress in Hormone Research, 57:411-34, 2002.

KUTSCHER, E.C., LUND, B.C., PERRY, P.J. Anabolic steroids: A review for the clinician. Sports Medicine, 32(5):285-96, 2002.

LUKE, J.L., FARB, A., VIRMANI, R., SAMPLE, R.H. Sudden cardiac death during exercise in a weight lifter using anabolic androgenic steroids: pathological and toxicological findings. Journal of Forensic Sciences, 35(6):1441-7, 1990.

MACHIDA, S., KARIYA, F., KOBAYASHI, K., NARUSAWA, M. Lack of effect or running training at two intensities on cardiac myosin isozyme composition in rats. The Japanese Journal of Physiology, 50(6): 577-83, 2000.

MANCIA, G., DE BACKER, G., DOMINICZAK, A., CIFKOVA, R., FAGARD, R., GERMANO, G., GRASSI, G., HEAGERTY, A.M., KJELDSEN, S.E., LAURENT, S., NARKIEWICZ, K., RUILOPE, L., RYNKIEWICZ, A., SCHMIEDER, R.E., STRUIJKER BOUDIER, H.A., ZANCHETTI, A., VAHANIAN, A., CAMM, J., DE CATERINA, R., DEAN, V., DICKSTEIN, K., FILIPPATOS, G., FUNCK-BRENTANO, C., HELLEMANS, I., KRISTENSEN, S.D., MCGREGOR, K., SECHTEM, U., SILBER, S., TENDERA, M., WIDIMSKY, P., ZAMORANO, J.L., KJELDSEN, S.E., ERDINE, S., NARKIEWICZ, K., KIOWSKI, W., AGABITI-ROSEI, E., AMBROSIONI, E., CIFKOVA, R., DOMINICZAK, A., FAGARD, R., HEAGERTY, A.M., LAURENT, S., LINDHOLM, L.H., MANCIA, G., MANOLIS, A., NILSSON, P.M., REDON, J., SCHMIEDER, R.E., STRUIJKER-BOUDIER, H.A., VIIGIMAA, M., FILIPPATOS, G., ADAMOPOULOS, S., AGABITI-ROSEI, E., AMBROSIONI, E., BERTOMEU, V., CLEMENT, D., ERDINE, S., FARSANG, C., GAITA, D., KIOWSKI, W., LIP, G., MALLION, J.M., MANOLIS, A.J., NILSSON, P.M., O'BRIEN, E., PONIKOWSKI, P., REDON, J., RUSCHITZKA, F., TAMARGO, J., VAN ZWIETEN, P., VIIGIMAA, M., WAEBER, B., WILLIAMS, B., ZAMORANO, J.L. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European Heart Journal, 28(12):1462-536, 2007.

MARQUES NETO, S.R., DA H SILVA, A., DOS SANTOS, M.C., FERRAZ, E.F., NASCIMENTO, J.H. The blockade of angiotensin AT1 and aldosterone receptors protects rats from synthetic androgen-induced cardiac autonomic dysfunction. Acta Physiologica (Oxf), 208(2):166-71, 2013.

NEGRÃO, C.E., RONDON, M.R.P.B. Exercício físico, hipertensão e controle barorreflexo da pressão arterial. Revista Brasileira de Hipertensão, 8:89-95, 2001.

NEVES, V.J., TANNO, A.P., CUNHA, T.S., FERNANDES, T., GUZZONI, V., DA SILVA, C.A., DE OLIVEIRA, E.M., MOURA, M.J., MARCONDES, F.K. Effects of nandrolone and resistance training on the blood pressure, cardiac electrophysiology, and expression of atrial β-adrenergic receptors. Life Sciences, 92(20-21):1029-35, 2013.

NORTON, G.R., TRIFUNOVIC, B., WOODIWISS, A.J. Attenuated beta-adrenoceptor-mediated cardiac contractile responses following androgenic steroid administration to sedentary rats. European Journal of Applied Physiology, 81(4):310-6, 2000.

NOTTIN, S., NGUYEN, L.D., TERBAH, M., OBERT, P. Cardiovascular effects of androgenic anabolic steroids in male bodybuilders determined by tissue Doppler imaging. The American Journal of Cardiology, 97(6):912-5, 2006.

OLIVARES, E.L., SILVEIRA, A.L., FONSECA, F.V., SILVA-ALMEIDA, C., CÔRTES, R.S., PEREIRA-JUNIOR, P.P., NASCIMENTO, J.H., REIS, L.C. Administration of an anabolic steroid during the adolescent phase changes the behavior, cardiac autonomic balance and fluid intake in male adult rats. Physiology & Behavior, 126:15-24, 2014.

OLIVEIRA, E.M., ALVES, G.B., BRUM, P.C., KRIEGER, J.E. Aspectos moleculares da hipertrofia dos músculos cardiac e esquelético após o treinamento físico. In: Negrão, C.E., Barreto, C.P. Cardiologia do Exercício. Ed. Manole; 2. ed. p.56-79, 2006.

OLIVEIRA, E.M., KRIEGER, J.E. Hipertrofia cardiaca e treinamento físico, aspectos moleculares. Hipertensão, 5(2):73-8, 2002.

RIBEIRO, P.C.P. O uso indevido de substâncias: esteroides anabolizantes e energéticos. Adolescência Latinoamericana, 2(2):97-101, 2000.

RIVERA-ARCE, J.C., MORALES-CRESPO, L., VARGAS-PINTO, N., VELÁZQUEZ, K.T., JORGE, J.C. Central effects of the anabolic steroid 17 alpha methyltestosterone in female anxiety. Pharmacology, Biochemistry and Behavior, 84(2):275-81, 2006.

ROCHA, F.L., CARMO, E.C., ROQUE, F.R., HASHIMOTO, N.Y., ROSSONI, L.V., FRIMM, C., ANÉAS, I., NEGRÃO, C.E., KRIEGER, J.E., OLIVEIRA, E.M. Anabolic steroids induce cardiac renin-angiotensin system and impair the beneficial effects of aerobic training in rats. American Journal of Physiology. Heart and Circulatory Physiology, 293:H3575-83, 2007.

SCHAIBLE, T.F., SCHEUER, J. Effects of physical training by running or swimming on ventricular performance of rat hearts. Journal of Applied Physiology, 46(4):854-60, 1979.

SCHEINOWITZ, M., KESSLER-ICEKSON, G., FREIMANN, S., ZIMMERMANN, R., SCHAPER, W., GOLOMB, E., SAVION N, ELDAR M. Short-and long-term swimming exercise training increases myocardial insulin-like growth factor-I gene expression. Growth Hormone & IGF Research, 13(1):19-25, 2003.

SILVA, G.J.J., KRIEGER, J.E. Hipertrofia ventricular esquerda na hipertensão arterial. Hipertensão, 3(4):156-60, 2000.

SØNDERGAARD, E.B., THUNE, J.J., GUSTAFSSON, F. Characteristics and outcome of patients with heart failure due to anabolic-androgenic steroids. Scandinavian Cardiovascular Journal, 48(6):339-42, 2014.

STOLT, A., KARILA, T., VIITASALO, M., MÄNTYSAARI, M., KUJALA, U.M., KARJALAINEN, J. QT interval and QT dispersion in endurance athletes and in power athletes using large doses of anabolic steroids. The American Journal of Cardiology, 84(3):364-6, 1999.

TANNER, S.M., MILLER, D.W., ALONGI, C. Anabolic steroid use by adolescents: prevalence, motives, and knowledge of risks. Clinical Journal of Sports Medicine, 5(2):108-15, 1995.

TANNO, A.P., NEVES, V.J., ROSA, K.T., CUNHA, T.S., GIORDANO, F.C., CALIL, C.M., GUZZONI, V., FERNANDES, T., DE OLIVEIRA, E.M., NOVAES, P.D., IRIGOYEN, M.C., MOURA, M.J., MARCONDES, F.K. Nandrolone and resistance training induce heart remodeling: Role of fetal genes and implications for cardiac pathophysiology. Life Sciences, 89(17-18):631-7, 2011.

THIBLIN, I., RUNESON, B., RAJS, J. Anabolic androgenic steroids and suicide. Annals of Clinical Psychiatry, 11(4): 223-31, 1999.

TURILLAZZI, E., PERILLI, G., DI PAOLO, M., NERI, M., RIEZZO, I., FINESCHI, V. Side effects of AAS abuse: an overview. Mini Reviews in Medicinal Chemistry, 11(5):374-89, 2011.

TYLICKI, A., KAWALKO, A., SOKOLSKA, J., STRUMILO, S. Effect of anabolic steroid nandrolone decanoate on the properties of certain enzymes in the heart, liver, and muscle of rats, and their effect on rats' cardiac electrophysiology. Hormone and Metabolic Research, 39(4):268-72, 2007.

URHAUNSEN, A., ALBERS, T., KINDERMANN, W. Are the cardiac effects of anabolic steroids abuse in strength athletes reversible? Heart, 90(5):496-501, 2004.

WILSON, J.D. Androgen abuse by athletes. Endocrine Reviews, 9(2):181-99, 1988.

WOODIWISS, A.J., TRIFUNOVIC, B., PHILIPPIDES, M., NORTON, G.R. Effects of an androgenic steroid on exercise-induced cardiac remodeling in rats. Journal of Applied Physiology, 88(2): 409-15, 2000.

Acessar Arquivo