Anabolic Steroid Use in Body Builders: An Echocardiographic Study of Left Ventricle Morphology and Function

Piccoli, B. De; Giada, Franco; Benettin, A.; Sartori, F; Piccolo, E

doi:10.1055/s-2007-1024703

Cited by 124 publications

(80 citation statements)

References 6 publications

(10 reference statements)

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“…1 Hypertension, 2 left ventricular hypertrophy, 3 and dyslipidaemia 4 have all been described. Whilst physical isometric training produces a physiological hypertrophy of the left ventricle, 5 it has been found that androgenic hormone use in the context of weight training produces pathological remodelling, 6 with an increase in the fibrous collagen component of the hypertrophied myocardium.…”

Section: Discussionmentioning

confidence: 99%

Body beautiful?

Owens¹,

Lyons²,

O’Brien³

1998

J Hum Hypertens

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Case reportMr LD, a 38-year-old male from Dublin was admitted with cellulitis of the right arm. On admission he was noted to be hypertensive, with a clinic reading of 200/115 mm Hg, and was referred for assessment by the cardiology department.The patient was a body builder ( Figure 1) and had been actively training for the past 10 years. He admitted to taking anabolic steroids over this time period (see Table 1). He had a positive family history of hypertension. Ambulatory blood pressure monitoring ( Figure 2) revealed severe systolic and diastolic hypertension, with preservation of the normal nocturnal dipping pattern. A work-up for target organ damage showed severe concentric left ventricular hypertrophy (Figure 3) on echocardiography, with a calculated left ventricular mass of 661 grams. He also had mild left atrial enlargement. The serum HDL cholesterol was 0.66 mmol/l, and the LDL fraction was 4.97 mmol/l. In view of the severity of the pressure elevation he underwent evaluation for an underlying primary cause for his hyper-

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Section: Discussionmentioning

confidence: 99%

Body beautiful?

Owens¹,

Lyons²,

O’Brien³

1998

J Hum Hypertens

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“…Several studies demonstrated an increase in left ventricular end diastolic volume, left ventricular mass and/or worsening diastolic function [11][12][13], while other studies demonstrated no cardiovascular changes with anabolic steroid use [14][15][16]. However, in bodybuilding, the doses used are often 10-100 times the therapeutic dose; in one report involving 24 weight lifters, the lowest dose was 350% of the usual therapeutic dose [17].…”

Section: Discussionmentioning

confidence: 99%

“…Poor visualization of the right ventricle, a poorly defined endocardial surface, irregular right ventricular geometry, and limited reproducibility of exercise studies are important limitations of echocardiography in evaluating the left and right ventricle [26]. Cardiac exercise CT has been shown to have excellent sensitivity and specificity for detecting coronary disease and for assessing changes in both right and left ventricles [11][12][13][14][15]27,34]. CT also allows clear apical delineation, and breast shadows, obesity, the diaphragm or bowel do not cause attenuation, and excellent reproducibility has been demonstrated, with interstudy, intraobserver and interobserver variations were 0.01±1.4, 0.06±2.0 and 0.28±2.1% respectively [14,28,29,36].…”

Section: Discussionmentioning

confidence: 99%

Effect of Testosterone and Resistance Training on Cardiac Mass and Contractility in Men with COPD

Budoff¹,

Mao²,

Rambod³

et al. 2011

J Allergy Ther

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Introduction: Testosterone therapy and resistance training have been demonstrated to improve muscle mass and strength in patients with testosterone deficiency. However the effects on cardiac mass and contractility of these interventions have not been identified in prospective placebo-controlled trials. The hypothesis of this trial was that resistance training and testosterone replacement would improve cardiac mass and contractility in male COPD patients with low testosterone levels. Methods:We conducted a 10 week trial in a 2 by 2 factorial design, randomizing 53 patients to replacement doses of testosterone enanthate (100 mg weekly) or placebo, as well as to a program of lower extremity resistance training or no exercise. We performed rest and exercise cardiac computed tomography (CCT) studies before and after 10 weeks of therapy to evaluate right and left heart function. Patients were injected with 40-50 ml of non-ionic, iodinated contrast and cine CCT images were obtained at rest. Patients were exercised to 60% of their maximal work rate on a semi-supine ergometer, then re-injected with another bolus of 40-50 ml of contrast and re-imaged. We evaluated cardiac output and left ventricular (LV) and right ventricular (RV) mass, LV and RV stroke volume, ejection fractions and end-diastolic volumes at rest and exercise, before and after therapy.Results: 42 men with COPD (mean FEV 1 =40%pred. pre-bronchodilator) and low testosterone levels (mean=320ng/dl) completed the 10 week protocol. Factorial analysis demonstrated that testosterone, but not resistance training increased LV and RV mass (by 4.9% and 8.3%, respectively). Resistance training, but not testosterone, was associated with increased LV ejection fraction at rest and during exercise (by 5.5% and 4.4%, respectively). In the entire study group, increases in both left and right ventricular mass were correlated with increases in lean body mass (assessed by DEXA) (r=0.49 and r=0.65, respectively). Conclusions:In men with COPD, testosterone replacement and strength training are associated with distinct alterations in cardiac structure and function. Specifically, resistance training improved ejection fraction, while testosterone increased lean body mass and LV mass.

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“…Common side effects include increased risk of cardiovascular disease, coronary artery disease, harmful changes in cholesterol levels and alterations in the heart structure [52,63,64]. These changes may lead to hypertension, cardiac arrhythmias, congestive heart failure, heart attacks or sudden cardiac death [65].…”

Section: Non Medical Use and Abuse Of Aasmentioning

confidence: 99%

Anabolic androgenic steroids effects on the immune system: a review

et al. 2009

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Androgenic anabolic steroids (AAS) are synthetic derivatives of the male hormone testosterone. AAS are used by athletes and recreational users of all ages to enhance their athletic performance and/or physical appearance. While several adverse effects of AAS abuse have been described, their effect on the immune system has not been clearly elucidated. The literature generally indicates that supraphysiologic doses of AAS with an intact steroid nucleus are immunosuppressive, that is they reduce immune cell number and function. While those with alterations to the steroid nucleus are immunostimulatory as they induce the proliferation of T cells and other immune cells. Specifically, several common AAS have been shown to adversely influence lymphocyte differentiation and proliferation, antibody production, Natural Killer Cytotoxic activity and the production of certain cytokines, thereby altering the immune reaction. These effects may be profound and long lasting depending on the dosing regime, types or combinations of AAS used and the extent and duration of AAS abuse. Nevertheless, the effects of long term use of supraphysiologic doses of AAS on the immune system remain uncertain.

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Anabolic Steroid Use in Body Builders: An Echocardiographic Study of Left Ventricle Morphology and Function

Cited by 124 publications

References 6 publications

Body beautiful?

Body beautiful?

Effect of Testosterone and Resistance Training on Cardiac Mass and Contractility in Men with COPD

Anabolic androgenic steroids effects on the immune system: a review

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