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

Tim Luijkx*, Birgitta K. Velthuis, Frank J. G. Backx, Constantinus F. M. Buckens, Niek H. J. Prakken, Rienk Rienks, Willem P. Th. M. Mali, Maarten J. Cramer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Participants: Cardiacmagnetic 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

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. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)664-668
Number of pages5
JournalInternational Journal of Cardiology
Issue number3
Publication statusPublished - 10-Aug-2013
Externally publishedYes


  • Athletes
  • Cardiac MRI
  • Anabolic androgenic steroids
  • Strength training
  • Ventricular function
  • Cardiac adaptation

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