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Ventricular structure, function, and focal fibrosis in anabolic steroid users: a CMR study

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European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Anabolic steroid (AS) misuse is widespread amongst recreational bodybuilders; however, their effects on the cardiovascular system are uncertain. Our aim was to document the impact of AS use on cardiac structure, function and the presence of focal fibrosis using the gold standard cardiovascular magnetic resonance imaging (CMR).

Methods

A cross-sectional cohort design was utilised with 21 strength-trained participants who underwent CMR imaging of the heart and speckle-tracking echocardiography. Thirteen participants (30 ± 5 years) taking AS for at least 2 years and currently on a “using”-cycle were compared with age and training-matched controls (n = 8; 29 ± 6 years) who self-reported never having taken AS (NAS).

Results

AS users had higher absolute left ventricular (LV) mass (220 ± 45 g) compared to NAS (163 ± 27 g; p < 0.05) but this difference was removed when indexed to fat-free mass. AS had a reduced right ventricular (RV) ejection fraction (AS 51 ± 4 % vs. NAS 59 ± 5 %; p < 0.05) and a significantly lower left ventricular E’:A’ myocardial tissue velocity ratio [AS 0.99(0.54) vs. NAS 1.78(0.46) p < 0.05] predominantly due to greater tissue velocities with atrial contraction. Peak LV longitudinal strain was lower in AS users (AS −14.2 ± 2.7 % vs. NAS −16.6 ± 1.9 %; p < 0.05). There was no evidence of focal fibrosis in any participant.

Conclusions

AS use was associated with significant LV hypertrophy, albeit in-line with greater fat-free mass, reduced LV strain, diastolic function, and reduced RV ejection fraction in male bodybuilders. There was, however, no evidence of focal fibrosis in any AS user.

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Abbreviations

AS:

Anabolic steroids

BMI:

Body mass index

CMR:

Cardiovascular magnetic resonance

HLA:

horizontal long axis

LGE:

Late gadolinium enhancement

LV:

Left ventricle

RV:

Right ventricle

ε:

Myocardial strain

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Acknowledgments

Dr. Ismail is supported by the British Heart Foundation, Imperial College London and the National Institute for Health Research Cardiovascular Biomedical Research Unit at the Royal Brompton Hospital. We would like to thank the staff of the Royal Brompton CMR Unit, in particular, Ms. Susan Clark, Ms. Bethan Cowley and Ms. Claire McLeod for their contributions to data collection. The results from this work do not constitute endorsement by ACSM.

Conflict of interest

There are no conflicts of interest for any of the authors.

Ethical standards

The study was conducted in accordance with the principles set out by the declaration of Helsinki. All participants provided written informed consent and local ethics approval was obtained.

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Authors and Affiliations

  1. Health Sciences Department, Liverpool Hope University, Hope Park, Liverpool, L16 9JD, UK

    Peter J. Angell

  2. CMR Unit, National Heart and Lung Institute, Royal Brompton Hospital, London, UK

    Tevfik F. Ismail, Andrew Jabbour, Gillian Smith, Annette Dahl, Ricardo Wage & Sanjay Prasad

  3. Research Institute for Sport and Exercise Sciences, Liverpool John Moore’s University, Liverpool, UK

    Greg Whyte, Daniel J. Green & Keith George

  4. School of Sport Science, Exercise and Health, The University of Western Australia, Nedlands, Australia

    Daniel J. Green

Authors
  1. Peter J. Angell
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  2. Tevfik F. Ismail
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  3. Andrew Jabbour
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  4. Gillian Smith
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  5. Annette Dahl
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  6. Ricardo Wage
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  7. Greg Whyte
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  9. Sanjay Prasad
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  10. Keith George
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Corresponding author

Correspondence to Peter J. Angell.

Additional information

Communicated by David C. Poole.

Peter J. Angell, Tevfik F. Ismail, Sanjay Prasad and Keith George have contributed equally to this work.

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Angell, P.J., Ismail, T.F., Jabbour, A. et al. Ventricular structure, function, and focal fibrosis in anabolic steroid users: a CMR study. Eur J Appl Physiol 114, 921–928 (2014). https://doi.org/10.1007/s00421-014-2820-2

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  • DOI: https://doi.org/10.1007/s00421-014-2820-2

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