Steroids Heart Study

[Lord Chronos]

Parsinnen reported the 12 year mortality to be 12.9% among 62 male powerlifters suspected of AAS use, compared to 3.1% in a control population.16
LVH is an independent risk factor for cardiovascular mortality and (through whatever mechanism) one might anticipate an excess cardiovascular mortality among AAS users in whom LVH occurs. In addition, the recognised association of AAS use with hypertension and dislipidaemia (raised low density lipoprotein and reduced high density lipoprotein cholesterol, and raised triglycerides),10 as well as influences on coagulation and platelet aggregation,10 might increase such risk. While it is debatable whether ASS use is indeed associated with an increased risk of premature cardiovascular death, 38% of the deaths in Parssinen’s powerlifting group were attributed to “myocardial infarction”,16 while several case reports have attributed myocardial infarction in athletes to ASS abuse.
In some cases, infarction has occurred without evident coronary thrombosis or atherosclerosis, leading to the hypothesis that ASS may induce coronary vasospasm in susceptible individuals.10 Similarly there are several case reports of increased thromboembolic risk.10 In a recent postmortem series of 34 AAS abusers aged 20–45 years (comprising 12 homicides, 11 suicides, 12 “accidental” deaths, and two of indeterminate cause), 12 of the deceased showed cardiac pathology. Findings included hypertrophy (7 cases), myocardial or endocardial fibrosis (5), cardiac steatosis (1), myocardial coagulation necrosis (2), and coronary atheroma (4). Cardiac changes were adjudged to have contributed to death by poisoning in two cases.17 However mediated, such a morbid burden is likely to rise with time. The US National Institute on Drug Abuse reported in 1999 that between 2.7–2.9% of year 8–12 high school teenagers had experimented at least once with AAS, representing a 38–50% rise since 1991.18
The influence of steroid hormones on the heart thus warrants further study. Evidently, the potential impact of steroid abuse on public health is a matter of concern. Perhaps more importantly, however, such studies might lead to a greater understanding of the shared mechanisms through which cardiac growth and cardiovascular disease are mediated. Such issues are increasingly exciting as the identification of local myocardial steroid synthesis (and its potential pathogenicity19) is paralleled by the demonstrated efficacy of steroid antagonists in cardiac disease.20 We might yet see a role for steroid antagonists such as aldosterone in the primary or secondary prevention of LVH, and its associated cardiovascular sequelae.

[Lord Chronos]

Sudden Cardiac Death During Exercise in a Weight Lifter Using Anabolic Androgenic Steroids: Pathological and Toxicological Findings

 Farb, A
 Fellow and chairman,  Armed Forces Institute of Pathology,  DC
 Virmani, R
 Fellow and chairman,  Armed Forces Institute of Pathology,  DC

 (Received 22 January 1990; accepted 1 February 1990)


Abstract

A 21-year-old, previously healthy weight lifter collapsed during a bench press workout. He had taken anabolic androgenic steroids parenterally for the previous several months. Pertinent autopsy findings included marked cardiac and renal hypertrophy and hepatosplenomegaly, with regional myocardial fibrosis and focal myocardial necrosis. Nandrolone (19-nor-testosterone) metabolites were identified in postmortem urine. The possible etiologies of the cardiac findings are discussed.

[Coach is Back!]

Where's the link for this study?

[Lord Chronos]

[Dilated cardiomyopathy in a user of anabolic steroids]

 [Article in Danish]

 Schollert PV, Bendixen PM.

 Medicinsk afdeling, Haderslev Sygehus.

 A case is described in which a 32-year old male body-builder was admitted with signs of cardiac incompensation after using anabolic steroids (AS) in large amounts for three weeks before admittance. Echo-cardiography showed a dilated left ventricle with decreased systolic function and electrocardiography showed atrial fibrillation. Response to treatment was good and he was discharged to further out-patient treatment. After nine weeks he was admitted with severe cardiac incompensation. There was no response to treatment and he died after three days. At autopsy the heart weighted 527 grams and was diffusely dilated. There were no signs of infarction. Microscopy showed scattered lymphocyte infiltrates consistent with dilated cardiomyopathy, possibly caused by myocarditis. There were no signs of bacterial infection, the patient was a non-alcoholic and no other known cause of myocarditis was shown. We conclude that the patient died from toxic myocarditis with dilated cardiomyopathy caused by AS.

[Lord Chronos]

Where's the link for this study?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768197/

http://eurheartj.oxfordjournals.org/content/17/10/1576.full.pdf

[Lord Chronos]

Serious cardiovascular side effects of large doses of anabolic steroids in weight lifters.

Nieminen MS, Rämö MP, Viitasalo M, Heikkilä P, Karjalainen J, Mäntysaari M, Heikkilä J.
Source

Department of Medicine, Helsinki University Central Hospital, Finland.
Abstract

Pathological cardiovascular manifestations are reported in four male patients, who had taken massive amounts of anabolic steroids while undergoing many years of strength training. One patient was referred because of ventricular fibrillation during exercise, one because of clinically manifest heart failure, and one because of arterial thrombus in his lower left leg. The fourth patient was persuaded to attend for a check-up because of a long history of massive use of anabolic steroids. All four patients had cardiac hypertrophy. Two of the patients had symptoms and signs of heart failure, and one of these two had a massive thrombosis in both right and left ventricles of his heart. After cessation of the use of anabolic steroids in the other patient with heart failure, left ventricular wall thickness reduced quickly from 12 to 10.5 mm, and fractional shortening increased from 14% to 27%. Endomyocardial biopsy revealed increased fibrosis in the myocardium in two of the three cases. HDL-cholesterol was 0.58 mmol.l-1 and 0.35 mmol.l-1 in the two patients still using multiple anabolic steroids at the time of investigation. The cardiovascular findings described in the present paper should warn all physicians and athletes about the possible serious acute and long-term side effects of the massive use of anabolic steroids.

[Lord Chronos]

Herz. 2006 Sep;31(6):566-73.
[Cardiovascular side effects of anabolic-androgenic steroids].
 [Article in German]
Kindermann W.
Source

Institut für Sport- und Präventivmedizin der Universität des Saarlandes, Saarbrücken. w.kindermann@mx.uni-saarland.de
Abstract

The intake of anabolic-androgenic steroids (AAS) leads to an increase in skeletal muscle mass and is prohibited as a doping measure in sport. AAS abuse is not limited to competitive athletes. It is also prevalent in subjects who do body building or resistance training for cosmetic reasons only. Out of the numerous and partly serious side effects, the cardiovascular ones are presented here. An increase in left ventricular muscle mass is well documented, and some researchers have even reported concentric hypertrophy. By contrast, resistance training without AAS intake does not lead to increased ventricular wall thickness. AAS do not affect the systolic function of the left ventricle, whereas diastolic function might be impaired. Different ultrastructural myocardial alterations have been documented in animal studies. In addition, AAS can induce arterial hypertension. Blood clotting and fibrinolysis are negatively affected, and several case studies of thrombi exist in young strength athletes. Changes in the concentration of blood lipoproteins, particularly a reduction in vessel-protective HDL cholesterol, can lead to early atherosclerosis. Many case reports exist about cardiac deaths in seemingly healthy subjects-most often body builders and other strength athletes. In fatal and nonfatal myocardial infarctions patent coronary arteries were proven frequently. Besides the prothrombotic effects of AAS, an impaired endothelial function and vasospasms are discussed hypothetically as pathomechanisms. Also, cardiomyopathies can occur due to AAS abuse.

[Lord Chronos]

Cardiovasc Toxicol. 2010 Dec;10(4):239-43.
Evidence of altered cardiac electrophysiology following prolonged androgenic anabolic steroid use.
Sculthorpe N, Grace F, Jones P, Davies B.
Source

Institute for Sport and Physical Activity Research, Department of Sport and Exercise Science, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK. nick.sculthorpe@beds.ac.uk
Abstract

The non-therapeutic use of androgenic anabolic steroids (AAS) is associated with sudden cardiac death. Despite this, there is no proposed mechanism by which this may occur. Signal-averaged ECG (SAECG) allows the assessment of cardiac electrical stability, reductions of which are a known risk factor for cardiac arrhythmias. The aim of the present study was to examine cardiac electrical stability using SAECG in a group (n = 15) of long-term AAS users (AAS use 21.3 ± 3.1 years) compared with a group (n = 15) of age-matched weight lifters (WL) and age-matched sedentary controls [C (n = 15)]. AS, WL and C underwent SAECG analysis at rest and following an acute bout of exercise to volitional exhaustion. SAECGs were analyzed using a 40 Hz filter and were averaged over 200 beats. Results indicate a non-significant trend for increased incidence of abnormal SAECG measures at rest in AS (P = 0.55). However, AS demonstrated a significantly higher incidence of abnormalities of SAECG following exercise than C or WL (P < 0.05). In conclusion, the higher incidence of abnormal SAECG measurements immediately post-exercise in the AAS group places them at a greater risk of sudden death. The present study provides a strong contraindication to the use of AAS.

[Lord Chronos]

J Mol Cell Cardiol. 2010 Aug;49(2):165-75. Epub 2010 May 10.

Chronic treatment with anabolic steroids induces ventricular repolarization disturbances: cellular, ionic and molecular mechanism.

Medei E, Marocolo M, Rodrigues Dde C, Arantes PC, Takiya CM, Silva J, Rondinelli E, Goldenberg RC, de Carvalho AC, Nascimento JH.
Source

Universidade Federal do Rio de Janeiro, Brazil.
Abstract

The illicit use of supraphysiological doses of androgenic steroids (AAS) has been suggested as a cause of arrhythmia in athletes. The objectives of the present study were to investigate the time-course and the cellular, ionic and molecular processes underlying ventricular repolarization in rats chronically treated with AAS. Male Wistar rats were treated weekly for 8 weeks with 10mg/kg of nandrolone decanoate (DECA n=21) or vehicle (control n=20). ECG was recorded weekly. Action potential (AP) and transient outward potassium current (I(to)) were recorded in rat hearts. Expression of KChIP2, Kv1.4, Kv4.2, and Kv4.3 was assessed by real-time PCR. Hematoxylin/eosin and Picrosirius red staining were used for histological analysis. QTc was greater in the DECA group. After DECA treatment the left, but not right, ventricle showed a longer AP duration than did the control. I(to) current densities were 47.5% lower in the left but not in the right ventricle after DECA. In the right ventricle the I(to) inactivation time-course was slower than in the control group. After DECA the left ventricle showed lower KChIP2 ( approximately 26%), Kv1.4 ( approximately 23%) and 4.3 ( approximately 70%) expression while the Kv 4.2 increased in 4 ( approximately 250%) and diminished in 3 ( approximately 30%) animals of this group. In the right ventricle the expression of I(to) subunits was similar between the treatment and control groups. DECA-treated hearts had 25% fewer nuclei and greater nuclei diameters in both ventricles. Our results strongly suggest that supraphysiological doses of AAS induce morphological remodeling in both ventricles. However, the electrical remodeling was mainly observed in the left ventricle.

[Lord Chronos]

Med Sci Sports Exerc. 2010 May;42(5):865-71.
Abnormal neurovascular control in anabolic androgenic steroids users.
Alves MJ, Dos Santos MR, Dias RG, Akiho CA, Laterza MC, Rondon MU, Moreau RL, Negrāo CE.
Source

Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Abstract
PURPOSE:

Previous studies showed that anabolic androgenic steroids (AAS) increase vascular resistance and blood pressure (BP) in humans. In this study, we tested the hypotheses 1) that AAS users would have increased muscle sympathetic nerve activity (MSNA) and reduced forearm blood flow (FBF) compared with AAS nonusers and 2) that there would be an association between MSNA and 24-h BP.
METHODS:

Twelve AAS users aged 31 +/- 2 yr (means +/- SE) and nine age-matched AAS nonusers aged 29 +/- 2 yr participated in the study. All individuals were involved in strength training for at least 2 yr. AAS was determined by urine test (chromatography-mass spectrometry). MSNA was directly measured by microneurography technique. FBF was measured by venous occlusion plethysmography. BP monitoring consisted of measures of BP for 24 h.
RESULTS:

MSNA was significantly higher in AAS users than that in AAS nonusers (29 +/- 3 vs 20 +/- 1 bursts per minute, P = 0.01). FBF (1.92 +/- 0.17 vs 2.77 +/- 0.24 mL x min(-1) x 100 mL(-1), P = 0.01) and forearm vascular conductance (2.01 +/- 0.17 vs 2.86 +/- 0.31 U, P = 0.02) were significantly lower in AAS users than that in AAS nonusers. Systolic (131 +/- 4 vs 120 +/- 3 mm Hg, P = 0.001), diastolic (74 +/- 4 vs 68 +/- 3 mm Hg, P = 0.02), and mean BP (93 +/- 4 vs 86 +/- 3 mm Hg, P = 0.005) and heart rate (74 +/- 3 vs 68 +/- 3 bpm, P = 0.02) were significantly higher in AAS users when compared with AAS nonusers. Further analysis showed that there was a significant correlation between MSNA and 24-h mean BP (r = 0.75, P = 0.002).
CONCLUSIONS:

AAS increases MSNA and reduces muscle blood flow in young individuals. In addition, the increase in BP levels in AAS users is associated with augmented sympathetic outflow. These findings suggest that AAS increases the susceptibility for cardiovascular disease in humans.

[Lord Chronos]

Hum Exp Toxicol. 2009 May;28(5):273-83.

Doping and effects of anabolic androgenic steroids on the heart: histological, ultrastructural, and echocardiographic assessment in strength athletes.

Hassan NA, Salem MF, Sayed MA.
Source

Department of Forensic Medicine, Faculty of Medicine, Tanta University, Egypt. neven_prof@yahoo.com
Abstract

Anabolic androgenic steroids (AAS) are used by some athletes to enhance performance despite the health risk they may pose in some persons. This work was carried out to evaluate the possible structural and functional alterations in the heart using two-dimensional, M-mode, tissue Doppler imaging (TDI) and strain rate imaging (SRI) in athletes using supraphysiological doses of AAS. Additionally, the histological and ultrastructural changes in cardiac muscles of adult albino rats after injection of sustanon, as an example of AAS, were studied. Fifteen male bodybuilders using anabolic steroids constituted group 1, five male bodybuilders who are not using anabolic steroids constituted group 2, and five nonathletic males constituted negative control group (group 3). They were investigated by two-dimensional, M-mode, TDI and SRI. This study was performed on 30 adult albino rats. They were divided into two groups. Group I (Control group) (10) was subdivided into negative control, subgroup 1a (5), and subgroup 1b (5), which received 0.8 ml olive oil intramuscular once a week for 8 weeks. Group II (Experimental group) (20) received sustanon 10 mg/kg intramuscularly once a week for 8 weeks. The heart specimens were prepared for light microscopy and transmission electron microscopy. Echocardiographic results showed that bodybuilders who use steroids have smaller left ventricular dimension with thicker walls, impaired diastolic function, as well as higher peak systolic strain rate in steroid-using bodybuilders as compared to the other two groups. Light microscopy examination of cardiac muscle fibers showed focal areas of degeneration with loss of striations and vacuolation in the experimental group. Ultrastructural examination showed disturbance of the banding pattern of the cardiac muscle fiber with disintegration, loss of striations, dehiscent intercalated disc, and interrupted Z-bands. Administration of supraphysiological doses of AAS caused severe deleterious effects in the myocardium both in athletes and in experimental animals. The SRI shows promise in the early detection of systolic dysfunction in those athletes who use steroids.

[Lord Chronos]

I decided to download 140 odd studies, after reading them I have come to the conclusion that steroids clearly have no effect on the heart, however there is risk that one could lose striations on the heart, which for any true bodybuilder I imagine is a scary thought. I thought I would post a few up here.

If anyone wants me to post the other 130 studies, please let me know.

[dyslexic]

Lord Chromos or Chronos whatevah...


is increasing his post count rapidly.

[Lord Chronos]

Lord Chromos or Chronos whatevah...


is increasing his post count rapidly.

No sir, I wont post anymore.

Chromos? How can you get the spelling wrong?

[Emmortal]

Where are the studies showing people who were actual usuers (instead of being "suspected of use") against those that are verfied as clean in the same field? Such as powerlifters who are verified users against powerlifters who are clean.

Anarobic exercise, steroids or not, has shown to put a lot of stress on the heart so attributing steroids as the sole cause of these issues is patently false at best.

[Lord Chronos]

Where are the studies showing people who were actual usuers (instead of being "suspected of use") against those that are verfied as clean in the same field? Such as powerlifters who are verified users against powerlifters who are clean.

Anarobic exercise, steroids or not, has shown to put a lot of stress on the heart so attributing steroids as the sole cause of these issues is patently false at best.

Here's one.

http://eurheartj.oxfordjournals.org/content/17/10/1576.full.pdf

Dont shoot the messenger, I said i dont believe steroids have any effect on the heart.

However your comment about comparing Anerobic exercise putting stress on the heart is incorrect. yes they put stress on the heart but the stress stimulates a positive response and adaptation in cardiac tissue. There is no studies showing powerlifting or weightlifting without the use of steroids having any negative effect on the heart. However I am open and willing to be proven wrong on that point if you have some proof.

BTW are you a gear user currently or in the past?

[chess315]

    There are other issues besides steroids involved though how heavy where these powerlifter a 250lb man having 7% more of a mortality rating then the general population would be no suprise drug or no drugs.   Also steroid users tend to abuse recreational drugs more then the general population. I mean smokers are more likely to be killed my drunk drivers and shot but it has nothing to do with smoking.

[gh2]

I decided to download 140 odd studies, after reading them I have come to the conclusion that steroids clearly have no effect on the heart, however there is risk that one could lose striations on the heart, which for any true bodybuilder I imagine is a scary thought. I thought I would post a few up here.

If anyone wants me to post the other 130 studies, please let me know.

I don't understand: you say you have 140 studies and going by the 10 you posted here all of them indicate problems with the heart after using AAS and then you say you conclude that AAS have no effect on the heart!?

Please elaborate?

[240 is Back]

Holy shit!  lol


In a recent postmortem series of 34 AAS abusers aged 20–45 years (comprising 12 homicides, 11 suicides, 12 “accidental” deaths, and two of indeterminate cause

[Lord Chronos]

I don't understand: you say you have 140 studies and going by the 10 you posted here all of them indicate problems with the heart after using AAS and then you say you conclude that AAS have no effect on the heart!?

Please elaborate?

Well the other 130 studies pretty much say the same thing.

However this subject has been discussed on Getbig pretty heavily amongst the biggest posters, including Gh15, and the overall conclusion is that there is no risk to the heart from steroids.

[suckmymuscle]

  Lord Chronos, thank you very much for your articles. Of course steroids are very bad for your heart. The only real debate is how long and in what doses you need to take them before artherosclerosis sets in.

SUCKMYMUSCLE

[Xerxes]

 

[cross-of-iron]

Well the other 130 studies pretty much say the same thing.

However this subject has been discussed on Getbig pretty heavily amongst the biggest posters, including Gh15, and the overall conclusion is that there is no risk to the heart from steroids.

  How can any tren user deny it's affect on the heart?

[pillowtalk]

 Lord Chronos, thank you very much for your articles. Of course steroids are very bad for your heart. The only real debate is how long and in what doses you need to take them before artherosclerosis sets in.

SUCKMYMUSCLE

Why not tell us (Mr time) that alcohol will give you cirrhosis of the Liver?? Sure it will, however, how many units per week & over what time period are we talking?? It's all about quantification.
P.s. I smoke also.

PT

[Lord Chronos]

Why not tell us (Mr time) that alcohol will give you cirrhosis of the Liver?? Sure it will, however, how many units per week & over what time period are we talking?? It's all about quantification.
P.s. I smoke also.

PT

Mr Time 

Well I'm not saying that alcohol will give cirrhosis of the liver. Nor am I saying anything else. I agree with you everything comes down to quantification. Although I wouldnt compare a reversible condition or illness with an irreversible one.