Found more to add and answers some of my questions.
"Heart. 2004 May;90(5):496-501.
Are the cardiac effects of anabolic steroid abuse in strength athletes reversible?
Urhausen A, Albers T, Kindermann W.
Institute of Sports and Preventive Medicine, University of Saarland Saarbruecken, Germany.
[email protected]
OBJECTIVE: To investigate the reversibility of adverse cardiovascular effects after chronic abuse of anabolic androgenic steroids (AAS) in athletes. METHODS: Doppler echocardiography and cycle ergometry including measurements of blood pressure at rest and during exercise were undertaken in 32 bodybuilders or powerlifters, including 15 athletes who had not been taking AAS for at least 12 months (ex-users) and 17 currently abusing AAS (users), as well as in 15 anabolic-free weightlifters. RESULTS: Systolic blood pressure was higher in users (mean (SD) 140 (10) mm Hg) than in ex-users (130 (5) mm Hg) (p < 0.05) or weightlifters (125 (10) mm Hg; p < 0.001). Left ventricular muscle mass related to fat-free body mass and the ratio of mean left ventricular wall thickness to internal diameter were not significantly higher in users (3.32 (0.48) g/kg and 42.1 (4.4)%) than in ex-users (3.16 (0.53) g/kg and 40.3 (3.8)%), but were lower in weightlifters (2.43 (0.26) g/kg and 36.5 (4.0)%; p < 0.001). Left ventricular wall thickness related to fat-free body mass was also lower in weightlifters, but did not differ between users and ex-users. Left ventricular wall thickness was correlated with a point score estimating AAS abuse in users (r = 0.49, p < 0.05). In all groups, systolic left ventricular function was within the normal range. The maximum late transmitral Doppler flow velocity (Amax) was higher in users (61 (12) cm/s) and ex-users (60 (12) cm/s) than in weightlifters (50 (9) cm/s; p < 0.05 and p = 0.054). CONCLUSIONS: Several years after discontinuation of anabolic steroid abuse, strength athletes still show a slight concentric left ventricular hypertrophy in comparison with AAS-free strength athletes."
"However this study on short term 16 week cycles, didn't find any changes to the heart.
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Int J Sports Med. 2003 Jul;24(5):344-51. Related Articles, Links
Prospective echocardiographic assessment of androgenic-anabolic steroids effects on cardiac structure and function in strength athletes.
Hartgens F, Cheriex EC, Kuipers H.
Netherlands Centre for Doping Affairs, Capelle aan den IJssel, The Netherlands.
[email protected]
Since the abuse of androgenic-anabolic steroids (AAS) has been associated with the occurrence of serious cardiovascular disease in young athletes, we performed two studies to investigate the effects of short-term AAS administration on heart structure and function in experienced male strength athletes, with special reference to dose and duration of drug abuse. In Study 1 the effects of AAS were assessed in 17 experienced male strength athletes (age 31 +/- 7 y) who self-administered AAS for 8 or 12 - 16 weeks and in 15 non-using strength athletes (age 33 +/- 5 y) in a non-blinded design. In Study 2 the effects of administration of nandrolone decanoate (200 mg/wk i. m.) for eight weeks were investigated in 16 bodybuilders in a randomised double blind, placebo controlled design. In all subjects M-mode and two-dimensional Doppler-echocardiography were performed at baseline and after 8 weeks AAS administration. In the athletes of Study 1 who used AAS for 12 - 16 weeks a third echocardiogram was also made at the end of the AAS administration period. Echocardiographic examinations included the determination of the aortic diameter (AD), left atrium diameter (LA), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness (IVS), posterior wall end diastolic wall thickness (PWEDWT), left ventricular mass (LVM), left ventricular mass index (LVMI), ejection fraction (EF) and right ventricular diameter (RVD). For assessment of the diastolic function measurements of E and A peak velocities and calculation of E/A ratio were used. In addition, acceleration and deceleration times of the E-top (ATM and DT, respectively) were determined. For evaluation of factors associated with stroke volume the aorta peak flow (AV) and left ventricular ejection times (LVET) were determined. In Study 1 eight weeks AAS self-administration did not result in changes of blood pressure or cardiac size and function. Additionally, duration of AAS self-administration did not have any impact on these parameters. Study 2 revealed that eight weeks administration of nandrolone decanoate did not induce significant alterations in blood pressure and heart morphology and function. Short-term administration of AAS for periods up to 16 weeks did not lead to detectable echocardiographic alterations of heart morphology and systolic and diastolic function in experienced strength athletes The administration regimen used nor the length of AAS abuse did influence the results. Moreover, it is concluded that echocardiographic evaluation may provide incomplete assessment of the actual cardiac condition in AAS users since it is not sensitive enough to detect alterations at the cellular level. Nevertheless, from the present study no conclusions can be drawn of the cardiotoxic effects of long term AAS abuse."
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It is important to understand that weight training alone can cause cardiac hypertrophy as most bodybuilders and powerlifters have enlarged hearts. This remodeling of the heart occurs so the heart can handle the blood pressure levels that can occur during heavy lifting and expecially power lifting. This remodeling is a positive effect of adaptation and without it most powerlifters would have a massive heart attack when trying to squat 1000 lb
Now to further complicate the issue off AAS and heart.
Med Sci Sports Exerc. 1985 Dec;17(6):701-4. Related Articles, Links
Left ventricular size and function in body builders using anabolic steroids.
Salke RC, Rowland TW, Burke EJ.
Although controversial, there is evidence to support a direct effect of improved skeletal muscle strength and mass by anabolic steroids in weight-training athletes. The influence of these drugs on the myocardial hypertrophy demonstrated by these individuals is unknown. Echocardiographic measurements of left ventricular dimensions and function were evaluated in 15 steroid-using body builders and compared to body builders not taking these drugs as well as an inactive control group. Significant increase in left ventricular posterior wall (LVPW) and ventricular septal (VS) thickness as well as an elevated VS/LVPW ratio were noted in both weight-lifting groups compared to controls. There were no differences, however, between the weight lifters with and without anabolic steroid use in any of the measurements. These data indicate no potentiating effects of these drugs on the myocardial hypertrophy observed with weight training.
PMID: 4079743 [PubMed - indexed for MEDLINE]
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The study below notes left ventricle thickening in power athletes with or without the use of anabolic steroids.
The conclusion of this study is one of the most accepted theories called the sqeeze theory. The belief of which is that strengh training causes morphalogical changes to the heart or cardiac remodelling as an adaptation or conditioning response so the heart can handle aterial pressure under extreme loads. Because anabolic steroids augment/enhance power and the training response. In many cases leading to heavier weights being lifted than could be done naturally the cardic remodeling is also augmented due to the changes in loading (weight).
Cardiology. 1998 Oct;90(2):145-8. Related Articles, Links
Left ventricular wall thickening does occur in elite power athletes with or without anabolic steroid Use.
Dickerman RD, Schaller F, McConathy WJ.
Department of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Tex., USA.
Reports on the occurrence of left ventricular wall thickening in resistance-trained athletes have rejected the possibility for this physiological adaptation to occur without concomitant anabolic steroid abuse. Others have concluded short bursts of arterial hypertension that occur with maximal weight lifting are not sufficient to induce left ventricular wall thickening, and left ventricular wall thickness >/=13 mm should not be found in pure resistance-trained athletes. Therefore, we examined 4 elite resistance-trained athletes by two-dimensional echocardiography. In addition, we retrospectively examined the individual left ventricular dimensions of 13 bodybuilders from our previous echocardiographic studies. All 4 elite resistance-trained athletes had left ventricular wall thicknesses beyond 13 mm. One of the elite bodybuilders has the largest left ventricular wall thickness (16 mm) ever reported in a power athlete. Retrospectively, 43% of the drug-free bodybuilders and 100% of the steroid users had left ventricular wall thickness beyond the normal range of 11 mm. In addition, 1 drug-free subject and 3 steroid users were beyond the critical mark of 13 mm. No subjects demonstrated diastolic dysfunction. In contrast to previous reports, we have demonstrated that left ventricular wall thicknesses >/=13 mm can be found routinely in elite resistance-trained athletes. The use of anabolic steroids concomitant with intensive resistance exercise does appear to augment left ventricular size without dysfunction. Anabolic steroids may accelerate left ventricular wall thickening indirectly by increasing strength, thus augmenting the pressor response.
PMID: 9778553 [PubMed - indexed for MEDLINE]
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"A final issue which is not addressed when it comes to the heart is that of blood pressure. While Left ventricular hypertrophy may not be a direct effect or even a side-effect of anabolic steroid usage. However LVH is a direct effect of hypertension (high blood preesure) LVH and hypertension is also what cardiologists classify as high risk for diastolic failure (heart attack)
Your #1 concern on cycle should always be to keep your blood pressure under control and as I've said here for years...you should NEVER start a cycle while your blood pressure is high, uncontrolled, or both. You should also NEVER continue with a cycle that causes your blood pressure to elevate over 140/90."
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