Anabolic androgenic steroid use is associated with ventricular dysfunction on cardiac MRI in strength trained athletes

AbstractBackgroundUncertainty remains about possible cardiac adaptation to resistance training. Androgenic anabolic steroids (AAS) use plays a potential role and may have adverse cardiovascular effects.ObjectiveTo elucidate the effect of resistance training and of AAS-use on cardiac dimensions and function.ParticipantsCardiac magnetic resonance (CMR) were performed in 156 male subjects aged 18–40years: 52 non-athletes (maximum of 3exercise hours/week), 52 strength–endurance (high dynamic–high static, HD–HS) athletes and 52 strength (low dynamic–high static, LD–HS) trained athletes (athletes ≥6exercise hours/week). 28 LD–HS athletes denied and 24 admitted to AAS use for an average duration of 5years (range 3months–20years).ResultsNo 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