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

Area of Science:

• Cardiology
• Sports Medicine
• Pharmacology

Background:

• Anabolic steroid (AS) misuse is prevalent among recreational bodybuilders.
• The cardiovascular effects of AS use remain uncertain.
• Cardiovascular magnetic resonance imaging (CMR) is the gold standard for assessing cardiac structure and function.

Purpose of the Study:

• To investigate the impact of AS use on cardiac structure, function, and focal fibrosis.
• To compare cardiac parameters between AS users and non-users (NAS) using CMR.

Main Methods:

• Cross-sectional cohort study of 21 strength-trained participants.
• CMR imaging and speckle-tracking echocardiography were performed.
• Thirteen AS users (≥2 years use, current cycle) were compared to 8 age/training-matched NAS controls.

Main Results:

• AS users exhibited higher absolute left ventricular (LV) mass, normalized by fat-free mass.
• Reduced right ventricular (RV) ejection fraction (51% vs. 59%) and impaired LV diastolic function (E':A' ratio) were observed in AS users.
• AS users showed lower peak LV longitudinal strain (-14.2% vs. -16.6%).
• No evidence of focal fibrosis was detected in any participant.

Conclusions:

• AS use is associated with significant LV hypertrophy, reduced LV strain, and diastolic dysfunction in male bodybuilders.
• A reduced RV ejection fraction was noted in AS users.
• Despite cardiac alterations, no focal fibrosis was found in AS users.