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REPLY
Physiologic Left Ventricular Cavity Dilatation in Elite Athletes
Antonio Pelliccia, MD, and
Barry J. Maron, MD
5 October 1999 | Volume 131 Issue 7 | Page 546
IN RESPONSE:
Dr. Ribeiro asks whether the marked left ventricular remodeling we described in elite athletes may have been partially determined by anabolic steroid use. This intriguing question also suggests that the substantial left ventricular cavity dilatation present in some highly trained athletes may be not an entirely physiologic phenomenon and possibly an expression of a pathologic condition. Athletes examined as a part of our medical program at the Institute of Sports Science in Rome have denied the use of all illicit drugs, including anabolic steroid hormones; however, actual testing for these drugs is not a routine part of our program. Although we cannot exclude the possibility that some athletes may have been taking steroid hormones, it seems unlikely that a substantial proportion of cyclists, cross-country skiers, and rowers/canoeists (the athletes with the most marked left ventricular cavity enlargement) have been using anabolic steroids over the long term to enhance performance. Excellence in these disciplines primarily requires high aerobic power and anaerobic threshold, which are not likely to be enhanced by long-term use of anabolic steroid hormones.
Furthermore, the precise effect of these hormones on left ventricular structure remains unresolved. In fact, although a mild increase in left ventricular wall thickness and mass has been described in power-trained athletes taking steroid hormones, no significant effect on left ventricular cavity has been reported (1-4). Therefore, it seems unlikely that the marked left ventricular cavity enlargement we described represents the consequence of anabolic steroid abuse.
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Author and Article Information
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Institute of Sports Science; Rome 00197, Italy (Pelliccia)
Minneapolis Heart Institute Foundation; Minneapolis, MN 55407 (Maron)
1. Salke RC, Rowland TW, Burke EJ. Left ventricular size and function in body builders using anabolic steroids Med Sci Sports Exerc. 1985;17:701-4.[Medline]
2. Urhausen A, Holpes R, Kindermann W. One- and two-dimensional echocardiography in bodybuilders using anabolic steroids Eur J Appl Physiol. 1989;58:633-40.
3. De Piccoli B, Giada F, Benettin A, Sartori F, Piccolo E. Anabolic steroid use in body builders: an echocardiographic study of left ventricle morphology and function Int J Sports Med. 1991;12:408-12.[Medline]
4. Thompson PD, Sadaniantz A, Cullinane EM, Bodziony KS, Catlin DH, Torek-Both G, et al. Left ventricular function is not impaired in weight-lifters who use anabolic steroids J Am Coll Cardiol. 1992;19:278-82.[Abstract]
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