Abstract 16886: Impact of Anabolic Steroid Use on the Cardiac Interstitium in Recreational Bodybuilders: a T1-Mapping Cardiovascular Magnetic Resonance Study

Abstract

Background: In contrast to physiological hypertrophy, many types of pathological left ventricular hypertrophy (LVH) have been associated with interstitial fibrosis, which results in expansion of the myocardial interstitial volume fraction. The abuse of anabolic steroids can induce LVH. However, whether this is associated with interstitial fibrosis is unknown. We sought to non-invasively investigate the effects of anabolic steroids on the cardiac interstitium using T1-mapping cardiovascular magnetic resonance (CMR).

Methods: Nine anabolic steroid-using recreational bodybuilders were studied along with 9 healthy controls. CMR was performed at 1.5T. Serial mid-short axis T1 maps were acquired before and after gadolinium contrast. Signal intensity-time curves for the myocardium and blood pool were used to determine T1 relaxation times through a non-linear curve-fit. The gadolinium partition coefficient (λ) was determined by plotting 1/T1 for the myocardium and blood pool at multiple time points after equilibrium and calculating the slope of the resultant linear regression line. This was corrected for hematocrit to determine the extracellular volume fraction (Ve), an index of interstitial fibrosis.

Results: There was significant LVH in the steroid user group (Table) and λ was significantly elevated compared to controls (0.45±0.04 vs 0.39±0.02, p=0.001); however, when corrected for the higher hematocrits in the steroid users, there was no significant difference in the Ve between the two groups (Ve 0.251±0.029 vs 0.237±0.015, p=0.23).

Conclusion: Anabolic steroids induce significant LVH which is not associated with expansion of the myocardial interstitium. Further work is required to determine the long-term effects of steroid abuse on myocardial structure and function.