Kardiovaskuläre Nebenwirkungen von anabol-androgenen Steroiden

Abstract

The intake of anabolic-androgenic steroids (AAS) leads to an increase in skeletal muscle mass and is prohibited as a doping measure in sport. AAS abuse is not limited to competitive athletes. It is also prevalent in subjects who do body building or resistance training for cosmetic reasons only. Out of the numerous and partly serious side effects, the cardiovascular ones are presented here. An increase in left ventricular muscle mass is well documented, and some researchers have even reported concentric hypertrophy. By contrast, resistance training without AAS intake does not lead to increased ventricular wall thickness. AAS do not affect the systolic function of the left ventricle, whereas diastolic function might be impaired. Different ultrastructural myocardial alterations have been documented in animal studies. In addition, AAS can induce arterial hypertension. Blood clotting and fibrinolysis are negatively affected, and several case studies of thrombi exist in young strength athletes. Changes in the concentration of blood lipoproteins, particularly a reduction in vessel-protective HDL cholesterol, can lead to early atherosclerosis. Many case reports exist about cardiac deaths in seemingly healthy subjects-most often body builders and other strength athletes. In fatal and nonfatal myocardial infarctions patent coronary arteries were proven frequently. Besides the prothrombotic effects of AAS, an impaired endothelial function and vasospasms are discussed hypothetically as pathomechanisms. Also, cardiomyopathies can occur due to AAS abuse. On the basis of the described possible cardiovascular side effects, it can be concluded that in cases of sudden cardiac deaths in young athletes, a misuse of AS should be excluded.

Cardiac Lesions Induced by Testosterone: Protective Effects of Dexrazoxane and Trimetazidine

“…Not infrequently athletes tend to abuse anabolic steroids derived from testosterone, and a number of sudden cardiac deaths have been reported in relation to this abuse [1][2][3][4]. Indeed, sudden deaths may be 4-6 fold more frequent in athletes with a history of anabolic steroid abuse [5,6].…”

Toxicology of Specific Substances

“…While deaths attributed to the misuse of stimulants were characterised by the more or less instantaneously occurring consequences such as intoxication, heat stroke and so on (Bernheim and Cox 1960), fatalities in relation to other doping agents such as AASs are usually time-delayed (up to many years) but provide numerous indicators in terms of morphological alterations (Kindermann 2006;Kohler et al 2008). These include cardiac hypertrophy, myocardial fibrosis and necrosis, hepatic and renal tumours and atherosclerosis, and have been observed in various autopsies of recreational or professional bodybuilders (Lüderwald et al 2008).…”

Doping im Sport

“…Die Sportler werden über einen gut organisierten Schwarzmarkthandel mit entsprechenden Steroidhormonen versorgt [4]. Zunehmend wird über Nebenwirkungen von Anabolika in diesem Bereich berichtet [5], wobei in medizinischen Fachzeitschriften auf zahlreiche Todesfälle durch Herzinfarkte hingewiesen wird. Darüber hinaus wurden vergleichende Untersuchungen publiziert, in denen Bodybuilder als Populationen herangezogen wurden, die eigenen Aussagen zufolge mit und ohne Anabolika trainierten, um Einflüsse durch Anabolika aufzuzeigen.…”

“…Eine verringerte Ausscheidung von Natrium bewirkt eine vermehrte Wassereinlagerung in bestimmten Geweben und führt somit zu einer Zunahme des Körpergewichts. Zudem gibt es Hinweise darauf, dass vermehrt Hypertonie bei und nach Anabolikamissbrauch auftritt, wobei der zugrundeliegende Mechanismus bisher unklar ist [5,10].…”

“…koronare Herzkrankheit, Bluthochdruck, Kardiomyopathie, Herzinsuffizienz, QT-Dispersion, Herzrhythmusstörungen, Herzthrombose usw. [5,[11][12][13][14].…”