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Physiologic Left Ventricular Cavity Dilatation in Elite Athletes
- Antonio Pelliccia, MD; and
- Barry J. Maron, MD
- Institute of Sports Science; Rome 00197, Italy (Pelliccia) Minneapolis Heart Institute Foundation; Minneapolis, MN 55407 (Maron)
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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.
Barry J. Maron, MD
Minneapolis Heart Institute Foundation; Minneapolis, MN 55407
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
