One- and two-dimensional echocardiography in bodybuilders using anabolic steroids

The object of this study was to investigate the possible concentric increase in the left ventricular (LV) wall thickness by intensive strength training and to differentiate between the specific effect of the strength training itself and the influence of anabolic drugs. In this study 21 top-level bodybuilders [users of anabolic steroids (A): n=14; non-users (N): n=7] underwent one-dimensional and two-dimensional echocardiography as well as a cycle ergometer test. In both groups blood pressure at rest and during ergometric exercise was within the normal range. In spite of the same amount of time being spent on training, A showed significantly better power results than N. Total heart volume (A=11.3±0.9 ml · kg^-1; N=11.9±0.9 ml · kg^-1) and LV muscle mass were almost identical in A and N and correlated significantly with body weight and lean body mass respectively. The body dimension-related diastolic LV diameter was significantly lower in A (0.567±0.062 mm · kg^-1) than in N (0.639±0.040 mm · kg^-1). An increase in the LV posterior wall (p<0.01) and septum thickness (ns) resulted in increased LV wall thickness:diameter (p<0.01) and LV muscle mass:volume (p<0.05) ratios in A (0.458±0.590; 1.38± 0.25 g · ml^-1) in comparison to N (0.356±0.077; 1.16±0.17 g · ml^-1). The septal:posterior wall thickness ratio was similar for both groups. Systolic LV function did not differ between A and N, while the isovolumetric relaxation time was prolonged in A (A=43.2±19.8 ms; N=28.6±9.9 ms; p<0.05), without correlating to wall thickness. Clearly thickened LV walls (>13 mm) were observed only in bodybuilders regularly using anabolic steroids (n=11). The study suggests that the intake of anabolic steroids combined with intense bodybuilding may induce a minor concentric increase in the ventricular wall thickness along with a minor impairment of diastolic function.