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Heart 2004;90:496-501; doi:10.1136/hrt.2003.015719
Copyright © 2004 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2004;90:496-501
© 2004 by BMJ Publishing Group & British Cardiac Society

CARDIOVASCULAR MEDICINE

Are the cardiac effects of anabolic steroid abuse in strength athletes reversible?

A Urhausen, T Albers and W Kindermann

Institute of Sports and Preventive Medicine, University of Saarland Saarbruecken, Germany

Correspondence to:
Correspondence to:
Dr Urhausen Axel
Institute of Sports and Preventive Medicine, University of Saarland, 66041 Saarbruecken, Germany; a.urhausen{at}rz.uni-sb.de

Objective: To investigate the reversibility of adverse cardiovascular effects after chronic abuse of anabolic androgenic steroids (AAS) in athletes.

Methods: Doppler echocardiography and cycle ergometry including measurements of blood pressure at rest and during exercise were undertaken in 32 bodybuilders or powerlifters, including 15 athletes who had not been taking AAS for at least 12 months (ex-users) and 17 currently abusing AAS (users), as well as in 15 anabolic-free weightlifters.

Results: Systolic blood pressure was higher in users (mean (SD) 140 (10) mm Hg) than in ex-users (130 (5) mm Hg) (p < 0.05) or weightlifters (125 (10) mm Hg; p < 0.001). Left ventricular muscle mass related to fat-free body mass and the ratio of mean left ventricular wall thickness to internal diameter were not significantly higher in users (3.32 (0.48) g/kg and 42.1 (4.4)%) than in ex-users (3.16 (0.53) g/kg and 40.3 (3.8)%), but were lower in weightlifters (2.43 (0.26) g/kg and 36.5 (4.0)%; p < 0.001). Left ventricular wall thickness related to fat-free body mass was also lower in weightlifters, but did not differ between users and ex-users. Left ventricular wall thickness was correlated with a point score estimating AAS abuse in users (r = 0.49, p < 0.05). In all groups, systolic left ventricular function was within the normal range. The maximum late transmitral Doppler flow velocity (Amax) was higher in users (61 (12) cm/s) and ex-users (60 (12) cm/s) than in weightlifters (50 (9) cm/s; p < 0.05 and p = 0.054).

Conclusions: Several years after discontinuation of anabolic steroid abuse, strength athletes still show a slight concentric left ventricular hypertrophy in comparison with AAS-free strength athletes.

Keywords: cardiomyopathy; drugs; echocardiography; hypertrophy


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eLetters:

Read all eLetters

Re: Are the cardiac effects of anabolic steroid abuse in strength athletes reversible?
Rob D. Dickerman, D.O., Ph.D
Online, 7 Jun 2004 [Full text]
Cardiac Maladaptation in athletes using anabolic steroides
Erdem Kasikcioglu
Online, 1 Jul 2004 [Full text]
Author's reply
Axel Urhausen, et al.
Online, 23 Jul 2004 [Full text]

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