Extreme cardiac hypertrophy in bodybuilders: Mechanical assessment of diastolic alteration

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This study aimed to evaluate the effect of bodybuilding (a combination of training and anabolic steroids abuse) on left ventricular diastolic function and, more specifically, on underlying mechanisms that characterize this function (e.g. filling pressure, relaxation and twist-untwist mechanics). Participants ( n = 44; aged 20 to 45 years) were from healthy sedentary population (SED, n = 15), strength-training athletes who had no history of anabolic steroid use (FOR, n = 15) and bodybuilders who had history of anabolic steroid use (AAS, n = 14). Each participant underwent 2D-strain echocardiography assessment to study morphological and functional parameters. Both the AAS and FOR groups had a concentric hypertrophy of the left ventricle. However, it was more severe in the AAS group. Left ventricular diastolic function was also significantly altered in the AAS group ( P < 0.05) as indicated by a decrease in E wave velocity and E/A ratio, a decrease in relaxation (E’ and SrL diastolic), an increase of filling pressure (i.e. an increase of SIDI), as well as a decrease in twist (in relation to decrease of apical rotation) and untwist velocities. Bodybuilding in conjunction with use of anabolic steroids induces concentric hypertrophy of the left ventricle and adversely alters left ventricular diastolic function.