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Changes in the Heart as a Result of AAS Abuse

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Changes in the Heart as a Result of AAS Abuse

The combination of physical exercise in the form of resistance training-bodybuilding, along with chemical enhancement with Performance Enhancing Drugs (PED’s), will eventually lead to hemodynamic changes to myocardium. These include the Ejection Fraction & Cardiac Output. Practically, they are translated as the performance of the heart and its ability to send blood to all systems, organs and tissues effectively. Left Ventricular Hypertrophy (LVH) is the result of this chronic abuse, as heart muscle adjusts to the provided stimulus. Heart muscle consists 50% from heart muscle fibers, while the other 50% from skeletal-striated muscle fibers. As a result, myocardium will correspond to AAS & PED’s and eventually will be hypertrophic, as skeletal (striated histological) muscles do as well. Moreover, considering the fact that androgenic receptors exist in several tissues of the human body, we can assume that heart will also react to:

1) Resistance training
2) AAS-PED’s.

The bodybuilder-weight lifter-strongman-sprinter, builds an enlarged heart with thick ventricular walls and interventricular septum, due to the reasons I just mentioned earlier. Ventricular capacity-volume is something indirectly proportional to ventricular walls thickening. This practically means that the thicker the ventricles are, the smaller the volume of the ventricles are. As a result, the thick heart of a bodybuilder is unable to eject an adequate amount of blood. Ejection Fraction lowers and generally EF is lower in athletes with large BMI. This is the reason why marathon runners and endurance cyclists have relatively small BMI and low body weight. An athlete with LVH in the long term will most probably develop diastolic hypertension.

However, the most critical thing about it is that a hypertrophic myocardium has much greater oxygen needs than usual. By this fact we can easily conclude that ischemic episodes are more likely to happen. Things are getting worse, if the athlete has poor eating habits with SFA’s, trans fat and he is a smoker. Consider that AAS abuse also is responsible for dyslipidemia and atherogenesis. All this dynamic cocktail could be responsible for an Acute Myocardial Infarction episode (AMI).

Things are different with the abuse of growth factors and Somatotropin (HGH) and Somatomedin C (IGF-1). As well known, those peptides work through the effect of hyperplasia, meaning the regeneration of new cells. This hypertrophic effect is based on cellular-nuclear mitotic divisions. A bodybuilder who abuses HGH & IGF1, will develop a heart that is enlarged as a whole; the so-called cardiomegaly. This means that heart’s size could reach as much as double of the normal size. According to Andreas Munzer’s autopsy (1996) at the age of 31, his heart was severely enlarged up to 600gr. This will cost in functional malfunctions of myocardium and will eventually lead to Left Heart Failure. LHF could be a chronic fatal situation, as Greg Kovacs passed away on 2014 at the age of 44.

On the other hand, the heart of an endurance athlete (marathon runner, cyclist, triathlon), will be developed with thin enlarged ventricles, that eject efficiently enough blood volume. The cardiac output is increased, while his heart beats slower that of the average individual (<60beats/min). This is an economy of energy the myocardium does, since there is no need for faster heart beating. Eventually, this reflects directly into a supreme physical condition and a cardiovascular capacity too. Actually, that kind of heart has a characteristic shape on a thoracic cavity X-ray, with LV sort of distending (cardio-thoracic index enlarged).

Cardiovascular physical activity is important for both kinds of abusers for the following reasons:

The bodybuilder strongman, or weight lifter has to perform 30′ of slow pace aerobic activity at 60% of MHR. This kind of exercise will eventually improve myocardium’s shape and size. LVF will be diminished and ventricles will shift to the model of an endurance athlete’s heart, as long as AAS & PED’s are ceased or at least taken with moderation and wisely. BMI is also a factor that has to be taken under consideration, as an overweight person, even at low fat percentage, has greater O2 demands for his myocardium. Therefore, heart has to perform harder and this is risky for an ischemic episode, such as Angina Pectoris.

High Density Lipoprotein increases with prolonged-sustained aerobic exercise. Afterwards, an improved atheromatic index is established (HDL/LDL). Thus, Cardio Vascular Disease risk can be diminished.

Low pace aerobic activity establishes the so-called ”collateral circulation”. This fact is practically translated into a vast vascular network that surrounds the myocardium and provides oxygen to the heart muscle. Through this kind of vessels, someone could survive under a heart attack ischemic episode (AMI).

We rarely see bodybuilders being able to run. And if that happens, they are either light-heavy weight, or they run for less time than other athletes and certainly much slower. There are several different reasons why a bodybuilder is unable to run:

The bodybuilder is an over weighted athlete, with BMI>30.Imagine a marathon runner carrying a bag in his back with an extra load of 50 pounds.

This extra load will have an impact on heart muscle’s performance; an enlarged myocardium and a much greater supply of 02 into skeletal muscles.

The bodybuilder-sprinter has trained-and developed-his fast twitch muscle fibers (white).These are rich in glycogen, while they have low tolerance in lactic acid. They also contain few mitochondria. On the other hand, an endurance athlete has developed his slow (red) muscle fibers, rich in myoglobin and in mitochondria as well. As a result, we can realize that ergophysiology parameters and rules are disproportional. Therefore, it is not fair asking for a sprinter, or bodybuilder (same explosive training) to act in a different way they have been trained. Similarly, it is unfair asking a marathon runner either to sprint, or to bench press.

The heart muscle of a bodybuilder is unable to pump blood efficiently, as the marathon runner does. Ventricular volume and capacities are way smaller rather than of the endurance athlete.

In conclusion, a bodybuilder has to follow a specific lifestyle, for longevity and medical prevention. These rules include:

Moderate aerobic physical activity of 60% MHR pace for 30′ on a daily basis.

Quit from smoking, saturated fats, trans fats, table salt and refined sugars

Use of anti-clotting agents (EPA, DHA, salicylic acid) as Hematocrite (Htc) is raised and blood viscosity increases, due to AAS abuse (&EPO)

Use of niacin (B3) and phytosterols (Lipid Stabil-MN), which improve HDL/LDL ratio, and supplementation with CoQ10 to support qualitative heart muscle’s metabolism.

Diet rich in white meat, fish, egg whites, vegetables, fruits, nuts, oats and fiber that prevent oxidation of LDL and raise of triglycerides, Total Cholesterol too, while they contribute to a low insulin resistance and decreased glycemic effect.
Measure blood pressure and heart rate on a weekly basis

Perform a stress test, U/S, and Holter 24-hr examination once a year.

Calculation of Hematocrit, Hemoglobin, Platelets, HDL, LDL, Total Cholesterol, Triglycerides, Fasting blood glucose. Those evaluations will ensure that there is no evidence of Metabolic Syndrome, Dyslipidemia, Polycythemia, and Diabetes Mellitus.


References:

1.) Peter J Angell1, Neil Chester1, et al. Performance enhancing drug abuse and cardiovascular risk in athletes: implications for the clinician. Br J Sports Med 2012; 46: i78-i84

2.) Manu Kaushik, Siva P. Sontineni, et al . Cardiovascular disease and androgens: A review. International Journal of Cardiology 2010; 142: 8–14

3.) H Kuipers, et al. Prospective echocardiographic assessment of androgenic-anabolic steroids effects on cardiac structure and function in strength athletes. Int J Sports Med 2003; 24: 344-351

4.) Image: Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Diagram_of_the_human_heart_(cropped).svg. See page for author
[GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)], via Wikimedia Commons

Source: https://anabolic.org/changes-in-the-heart-as-a-result-of-aas-abuse/
 

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Does cardio reverse the negative effects of gear use?

I
 
Cliff notes please.
 
Good read. In my career as a collegiate athlete, a cardiologists would meet with the outgoing Seniors and coach them on how to train down our enlarged hearts safely.
 
I've read somewhere that the use of Viagra decreases enlarged heart.
 
Good read. In my career as a collegiate athlete, a cardiologists would meet with the outgoing Seniors and coach them on how to train down our enlarged hearts safely.

I thought the study stated a enlarged heart due to cardiovascular activities wasn't a problem.

Was it from PED use?
 
I thought the study stated a enlarged heart due to cardiovascular activities wasn't a problem.

Was it from PED use?

It wasn’t from PED use.

My sport typically results in an enlarged heart as well as thickened walls. Over time your heart gains the ability to pump blood through a flexed muscle, thus relieving the accluded blood and increasing the cardiovascular efficiency over a given time period. In order to push the blood through these constricted muscles the heart grows in every dimension.

If someone were to completely stop all cardio the heart can’t retract fast enough, but the walls thin quickly. It makes the heart very inefficient and has resulted in pacemakers and several open heart surguries of people I know directly.

But it’s not a problem for most people. If you spend 4-6 hours training everyday for 4 years, exercise is second nature.


Edit: every year I was on the team at least one or two, and my Jr year three, athletes had to leave the team due to heart ailments. Hard to know if the sport was so grueling that it winnowed out the smallest imperfections, or if the sport created it. *shrug*
 
Last edited:
Excellent post..keep these coming!


Changes in the Heart as a Result of AAS Abuse

The combination of physical exercise in the form of resistance training-bodybuilding, along with chemical enhancement with Performance Enhancing Drugs (PED’s), will eventually lead to hemodynamic changes to myocardium. These include the Ejection Fraction & Cardiac Output. Practically, they are translated as the performance of the heart and its ability to send blood to all systems, organs and tissues effectively. Left Ventricular Hypertrophy (LVH) is the result of this chronic abuse, as heart muscle adjusts to the provided stimulus. Heart muscle consists 50% from heart muscle fibers, while the other 50% from skeletal-striated muscle fibers. As a result, myocardium will correspond to AAS & PED’s and eventually will be hypertrophic, as skeletal (striated histological) muscles do as well. Moreover, considering the fact that androgenic receptors exist in several tissues of the human body, we can assume that heart will also react to:

1) Resistance training
2) AAS-PED’s.

The bodybuilder-weight lifter-strongman-sprinter, builds an enlarged heart with thick ventricular walls and interventricular septum, due to the reasons I just mentioned earlier. Ventricular capacity-volume is something indirectly proportional to ventricular walls thickening. This practically means that the thicker the ventricles are, the smaller the volume of the ventricles are. As a result, the thick heart of a bodybuilder is unable to eject an adequate amount of blood. Ejection Fraction lowers and generally EF is lower in athletes with large BMI. This is the reason why marathon runners and endurance cyclists have relatively small BMI and low body weight. An athlete with LVH in the long term will most probably develop diastolic hypertension.

However, the most critical thing about it is that a hypertrophic myocardium has much greater oxygen needs than usual. By this fact we can easily conclude that ischemic episodes are more likely to happen. Things are getting worse, if the athlete has poor eating habits with SFA’s, trans fat and he is a smoker. Consider that AAS abuse also is responsible for dyslipidemia and atherogenesis. All this dynamic cocktail could be responsible for an Acute Myocardial Infarction episode (AMI).

Things are different with the abuse of growth factors and Somatotropin (HGH) and Somatomedin C (IGF-1). As well known, those peptides work through the effect of hyperplasia, meaning the regeneration of new cells. This hypertrophic effect is based on cellular-nuclear mitotic divisions. A bodybuilder who abuses HGH & IGF1, will develop a heart that is enlarged as a whole; the so-called cardiomegaly. This means that heart’s size could reach as much as double of the normal size. According to Andreas Munzer’s autopsy (1996) at the age of 31, his heart was severely enlarged up to 600gr. This will cost in functional malfunctions of myocardium and will eventually lead to Left Heart Failure. LHF could be a chronic fatal situation, as Greg Kovacs passed away on 2014 at the age of 44.

On the other hand, the heart of an endurance athlete (marathon runner, cyclist, triathlon), will be developed with thin enlarged ventricles, that eject efficiently enough blood volume. The cardiac output is increased, while his heart beats slower that of the average individual (<60beats/min). This is an economy of energy the myocardium does, since there is no need for faster heart beating. Eventually, this reflects directly into a supreme physical condition and a cardiovascular capacity too. Actually, that kind of heart has a characteristic shape on a thoracic cavity X-ray, with LV sort of distending (cardio-thoracic index enlarged).

Cardiovascular physical activity is important for both kinds of abusers for the following reasons:

The bodybuilder strongman, or weight lifter has to perform 30′ of slow pace aerobic activity at 60% of MHR. This kind of exercise will eventually improve myocardium’s shape and size. LVF will be diminished and ventricles will shift to the model of an endurance athlete’s heart, as long as AAS & PED’s are ceased or at least taken with moderation and wisely. BMI is also a factor that has to be taken under consideration, as an overweight person, even at low fat percentage, has greater O2 demands for his myocardium. Therefore, heart has to perform harder and this is risky for an ischemic episode, such as Angina Pectoris.

High Density Lipoprotein increases with prolonged-sustained aerobic exercise. Afterwards, an improved atheromatic index is established (HDL/LDL). Thus, Cardio Vascular Disease risk can be diminished.

Low pace aerobic activity establishes the so-called ”collateral circulation”. This fact is practically translated into a vast vascular network that surrounds the myocardium and provides oxygen to the heart muscle. Through this kind of vessels, someone could survive under a heart attack ischemic episode (AMI).

We rarely see bodybuilders being able to run. And if that happens, they are either light-heavy weight, or they run for less time than other athletes and certainly much slower. There are several different reasons why a bodybuilder is unable to run:

The bodybuilder is an over weighted athlete, with BMI>30.Imagine a marathon runner carrying a bag in his back with an extra load of 50 pounds.

This extra load will have an impact on heart muscle’s performance; an enlarged myocardium and a much greater supply of 02 into skeletal muscles.

The bodybuilder-sprinter has trained-and developed-his fast twitch muscle fibers (white).These are rich in glycogen, while they have low tolerance in lactic acid. They also contain few mitochondria. On the other hand, an endurance athlete has developed his slow (red) muscle fibers, rich in myoglobin and in mitochondria as well. As a result, we can realize that ergophysiology parameters and rules are disproportional. Therefore, it is not fair asking for a sprinter, or bodybuilder (same explosive training) to act in a different way they have been trained. Similarly, it is unfair asking a marathon runner either to sprint, or to bench press.

The heart muscle of a bodybuilder is unable to pump blood efficiently, as the marathon runner does. Ventricular volume and capacities are way smaller rather than of the endurance athlete.

In conclusion, a bodybuilder has to follow a specific lifestyle, for longevity and medical prevention. These rules include:

Moderate aerobic physical activity of 60% MHR pace for 30′ on a daily basis.

Quit from smoking, saturated fats, trans fats, table salt and refined sugars

Use of anti-clotting agents (EPA, DHA, salicylic acid) as Hematocrite (Htc) is raised and blood viscosity increases, due to AAS abuse (&EPO)

Use of niacin (B3) and phytosterols (Lipid Stabil-MN), which improve HDL/LDL ratio, and supplementation with CoQ10 to support qualitative heart muscle’s metabolism.

Diet rich in white meat, fish, egg whites, vegetables, fruits, nuts, oats and fiber that prevent oxidation of LDL and raise of triglycerides, Total Cholesterol too, while they contribute to a low insulin resistance and decreased glycemic effect.
Measure blood pressure and heart rate on a weekly basis

Perform a stress test, U/S, and Holter 24-hr examination once a year.

Calculation of Hematocrit, Hemoglobin, Platelets, HDL, LDL, Total Cholesterol, Triglycerides, Fasting blood glucose. Those evaluations will ensure that there is no evidence of Metabolic Syndrome, Dyslipidemia, Polycythemia, and Diabetes Mellitus.


References:

1.) Peter J Angell1, Neil Chester1, et al. Performance enhancing drug abuse and cardiovascular risk in athletes: implications for the clinician. Br J Sports Med 2012; 46: i78-i84

2.) Manu Kaushik, Siva P. Sontineni, et al . Cardiovascular disease and androgens: A review. International Journal of Cardiology 2010; 142: 8–14

3.) H Kuipers, et al. Prospective echocardiographic assessment of androgenic-anabolic steroids effects on cardiac structure and function in strength athletes. Int J Sports Med 2003; 24: 344-351

4.) Image: Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Diagram_of_the_human_heart_(cropped).svg. See page for author
[GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)], via Wikimedia Commons

Source: https://anabolic.org/changes-in-the-heart-as-a-result-of-aas-abuse/
 
This is a great reminder to take heart health seriously but falls a bit short IMHO.

Most cardiologists understand that with an active lifestyle there will almost always be some sort of heart hypertrophy and because of that if its "within specs" for an active individual it will be deemed as acceptable.

The danger here is that even though your heart may have undergone "acceptable" changes for someone with your athletic history you could still be very much in danger. The issue is that they cant tell just how much if any of the enlargement/thickening is due to the exercise and how much is due to other factors.

I have some personal experience in this area and its what got me to take a serious look at supplements. Ive preached it before but its worth repeating if it helps just one person..

When we lift our heart rate not only usually gets very high but our blood pressure goes through the roof as our hearts try and drive blood through contracted muscles. Even though the duration is short compared to endurance athletes it's the high exertion that causes the hypertrophy. The insidious problem that is usually overlooked is arterial stiffening due to cholesterol collection or calcification which also reduces blood flow to the heart itself AND makes the heart work even harder, not just during a workout but around the clock.

I was having some performance issues and lightheadedness upon standing. I had an enlarged and thickened left ventrical, ejection fraction on the cusp of the low end and a resting heart rate of around 50bpm. After hearing my history the doc kind of blew it off as me having an "athletic heart" and said to come back in a few months after telling me to take beta blockers and aspirin. I wasnt buying it and dove into anything and everything I could about nutrition and the roles various nutrients played in the body. As I began to learn more and more I stopped the meds and began a supplementation plan to make sure I was getting everything I may need. My endurance improved dramatically over the next year and 3 years later went back to the cardiologist for a checkup.

The Left ventricle was still enlarged but within the athletic range. The thickness was back within normal range and the ejection fraction was solidly in the middle of the ideal range. Now, had I just accepted the diagnosis I very well could have been in serious trouble even though by all accounts the doc said what he was seeing was expected for a lifelong athletic person.

All of the above recommendations are solid but will not address the underlying issue of calcification and cholesterol collection. There is no drug to my knowledge that will address the issue of nutrient deficiency yet most of the CVD issues we see are directly or at least indirectly caused by lack of proper nutrients to allow the body to heal and or put things where the belong.

Cholesterol clings to arterial walls because of arterial damage, heal the damage and the cholesterol becomes, by and large, a non-issue. The damage however can still cause cholesterol to cling even when cholesterol levels are low so the medical community continues to put a bullseye on cholesterol (to further bolster the market for statin drugs no doubt, just look at their growth). Its like blaming the car for drunk driving deaths. Additionally, things like calcium score are used to scare people and drive them to other drugs, all the while ignoring the actual cause.

There is ample reasearch that suggest, and literal shit tons of anecdotal evidence to support that if you heal the artierial damage the problem of cholesterol clog-age fades or completely is resolved. This is by and large a simple matter of large dose supplementation with Vit C. A key player in collagen synthesis which arteries are largely comprised of. An added benefit of vit C supplementation is that connective tissue is also collagen-based so for us older guys it can help immensely in keeping our joints healthy.

The calcification is also often simply due to the body not having the needed nutrients for it to make use of the calcium properly so it ends up in soft tissue or even collecting on bones externally in the form of bone spurs and the like. One need only read about the process by which calcium is used in the body and one can quickly see that ample supplies of vit D, Vit A and vit K are essential in the recipe for calcium to be put to proper use.
 
 
Bump.......because cardio is important to reduce and possibly reverse your damaged heart.
 
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