AAS + training alone can lead to an increased heart size. But several studies indicate that GH+AAS together seem to have a synergy and the heart mass was even GREATER than with AAS alone. Many all natural weight trainers and lifters have LVH as you mentioned (athletes heart). This is compounded by what we take. So if you take GH and AAS, odds are, you will have an enlarged heart to some degree. Whether its big enough to start causing poor output and heart failure is another question. Enlarged hearts run in my family and the only sauce any of them has been on is Tanqueray. I'm betting on a shitty echo result here at about age 50, boys. Themz the breaks.