Effects of anabolic-androgenic steroids on weight-lifters' myocardium : an ultrasonic videodensitometric study

Background: Recent bioptical data have shown that in weight-lifters (WL) under the pharmacological effects of anabolic-androgenic steroids (AAS), a focal increase in myocardial collagen content might occur as a reparative mechanism against a myocardial damage. Objective: The aim of this study was to investigate whether by using videodensitometry an early identification of the changes in myocardial texture is possible or a potential sign of myocardial damage, which can potentially occur in WL who have used AAS. Methods: Ten males WL (mean age: 32 ± 6 yr) who had regularly used AAS (users), were compared with 10 male WL at same training level (nonusers), who had not used any drugs and with 10 healthy sedentary controls (controls). The three groups were age and sex-matched. Echocardiographic parietal, septal thickness, and left ventricular mass (LVM bs ) were evaluated. Left ventricular systolic and diastolic functions were evaluated with Doppler examination. Quantitative analysis of echocardiographic digitized data was carried out with a calibrated 256 gray level digitization system, in order to calculate the mid-septum and the mid-posterior mean gray level (MGL) and to derive the cyclic variation index (CVI), i.e., the percent MGL variation during cardiac cycle. Results: The weight and relative body mass index were significantly higher in WL (P < 0.001); also the diastolic blood pressure was slightly but significantly higher in users in comparison both with nonusers and controls (P < 0.01). Systolic and diastolic functional parameters overlapped in the three groups. LVM bs was significantly higher in users (145 ± 17) and in nonusers (122 ±27) vs C (104 ± 18 g.m -2 ) (P <0.001 CVI at septum level showed significant differences: users: (-2.3 ± 31%) vs nonusers: (23 ± 8) and controls (29 ± 5) (P < 0.005); although no significant difference was found between nonusers and controls. CVI at posterior wall level followed a similar pattern. No relationship was found between CVI and LVM bs or wall thickness. Discussion: As brought out by videodensitometry, despite an increase in septal and parietal thickness and consequently in LVM bs , the physiological pressure overload that happens in WL during sport activities, in absence of any drugs, does not modify the myocardial ultrasonic texture. The abuse of AAS in WL, on the other hand, determines some alterations of the myocardial textural parameters. The real significance of these changes of myocardial texture detected with videodensitometry in WL who use anabolic-androgenic steroids, present also in the absence of other systolic and diastolic left ventricular functional indexes alterations, needs to be further explored with a larger population through the comparison with endobioptical data and with a follow-up study approach.