title: Anabolic androgenic steroid use is associated with ventricular dysfunction on cardiac MRI in strength trained athletes.
abstract: BACKGROUND
  Uncertainty remains about possible cardiac adaptation to resistance training. Androgenic anabolic steroids (AAS) use plays a potential role and may have adverse cardiovascular effects.
  
  
  OBJECTIVE
  To elucidate the effect of resistance training and of AAS-use on cardiac dimensions and function.
  
  
  METHODS
  Cardiac magnetic resonance (CMR) were performed in 156 male subjects aged 18-40 years: 52 non-athletes (maximum of 3 exercise hours/week), 52 strength-endurance (high dynamic-high static, HD-HS) athletes and 52 strength (low dynamic-high static, LD-HS) trained athletes (athletes ≥ 6 exercise hours/week). 28 LD-HS athletes denied and 24 admitted to AAS use for an average duration of 5 years (range 3 months-20 years).
  
  
  RESULTS
  No significant differences were found between non-athletes and non-AAS-using LD-HS athletes. AAS-using LD-HS athletes had significantly larger LV and RV volumes and LV wall mass than non-AAS-using LD-HS athletes, but lower than HD-HS athletes. In comparison to all other groups AAS-using LD-HS athletes showed lower ejection fractions of both ventricles (LV/RV EF 51/48% versus 55-57/51-52%) and lower E/A ratios (LV/RV 1.5/1.2 versus 1.9-2.0/1.4-1.5) as an indirect measure of diastolic function. Linear regression models demonstrated a significant effect of AAS-use on LV EDV, LV EDM, systolic function and mitral valve E/A ratio (all ANOVA-tests p<0.05).
  
  
  CONCLUSIONS
  Strength athletes who use AAS show significantly different cardiac dimensions and biventricular systolic dysfunction and impaired ventricular inflow as compared to non-athletes and non-AAS-using strength athletes. Increased ventricular volume and mass did not exceed that of strength-endurance athletes. These findings may help raise awareness of the consequences of AAS use.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. tluijkx@gmail.com
authors.forename: Tim
authors.initials: T
authors.lastname: Luijkx
authors.forename: Birgitta K
authors.initials: BK
authors.lastname: Velthuis
authors.forename: Frank J G
authors.initials: FJ
authors.lastname: Backx
authors.forename: Constantinus F M
authors.initials: CF
authors.lastname: Buckens
authors.forename: Niek H J
authors.initials: NH
authors.lastname: Prakken
authors.forename: Rienk
authors.initials: R
authors.lastname: Rienks
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Cramer
mesh_terms: D000293:Adolescent; D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects; D056352:Athletes; D003430:Cross-Sectional Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D015588:Observer Variation; D055070:Resistance Training / Q000379:methods; D013256:Steroids / Q000009:adverse effects; D045165:Testosterone Congeners / Q000009:adverse effects*; D018754:Ventricular Dysfunction / Q000139:chemically induced* / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D045930:Anabolic Agents; D013256:Steroids; D045165:Testosterone Congeners