Doctors can now conveniently distinguish early signs of myocardial changes that might herald cardiomyopathy in power athletes who have misused anabolic androgenic steroids.
With Doppler myocardial imaging (DMI) and strain rate imaging (SRI) they have been able to show subclinical impairment of systolic and diastolic function not detectable by standard Doppler echocardiography. Colour DMI analysis disclosed significantly smaller myocardial early diastolic to atrial diastolic wave ratio at the basal interventricular septum (IVS) and left ventricular (LV) lateral wall in steroid misusers than non‐users, including controls, and SRI disclosed lower peak systolic strain rate and strain in the middle IVS and LV lateral wall. Lower strain rate in the middle IVS depended on mean dose and duration of steroid use, and impaired LV strain in misusers correlated significantly with reduced performance during physical effort. Standard Doppler echocardiographic analyses were comparable for all subjects.
These results come from age matched male bodybuilders who had been misusing anabolic androgenic steroids for at least five years or had been free of them—45 in all—and 25 sedentary age matched male controls.
The effect of steroid misuse on long term cardiac risk has been hotly debated, but recent observation suggests that locally increased myocardial collagen in athletes under the influence of anabolic steroids might indicate an attempted repair response against myocardial damage.
▴ D'Andrea A, et al. British Journal of Sports Medicine 2007;41:149–155.
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