Key result
Anabolic steroid cessation reverses left ventricular hypertrophy, dropping LV mass index by ~150 g/m2.
Why the study?
Whether anabolic-androgenic steroid-associated cardiomyopathy is reversible after cessation of steroid abuse remains unsettled, with variable published outcomes.
Does cessation of anabolic-androgenic steroid abuse without cardiovascular pharmacotherapy improve myocardial hypertrophy and function in a patient with AAS-associated cardiomyopathy?
Case Report (n=1)
Does cessation of anabolic-androgenic steroid abuse without cardiovascular pharmacotherapy improve myocardial hypertrophy and function in a patient with AAS-associated cardiomyopathy?
Marked regression of anabolic-androgenic steroid-associated concentric LV hypertrophy can occur with AAS cessation alone over long-term follow-up, without the need for heart failure-directed pharmacotherapy.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We found that continued use of anabolic steroids among adult and middle-aged male strength athletes, even at lower dosages, was associated with a persistent thickening of the heart muscle, impaired contractions and worsening of the heart's ability to relax. As many as 17% of those who continued using AAS had severely reduced heart function. However, this could be reversed if the men stopped using anabolic steroids and continued to abstain from them over the long term.”
May indicate substantial LV mass regression after AAS cessation without pharmacotherapy; hypothesis-generating and requires prospective confirmation in larger cohorts.
The non-medical use of anabolic-androgenic steroids (AAS) is widespread among strength-training athletes and, increasingly, among men who have no medical indication for testosterone therapy. The cardiotoxic profile of these drugs includes concentric myocardial hypertrophy, systolic and diastolic dysfunction, myocardial fibrosis and an elevated risk of sudden cardiac death. Whether AAS-associated cardiomyopathy is reversible once AAS are withdrawn remains unsettled: published outcomes range from near-complete recovery to irreversible severe biventricular dysfunction. Here we report the case of a man first assessed at the age of 26, after 33 cumulative months of supraphysiological AAS abuse, and reassessed eight years later. Marked regression of concentric left ventricular hypertrophy, with an accompanying reduction in right ventricular free wall thickness, was documented: left ventricular (LV) mass index fell from 261 to 111 g/m2 (57%), interventricular septal and posterior wall thickness decreased by 47% and 49%, and relative wall thickness fell from 0.86 to 0.43. The transmitral E/A ratio rose from 1.18 to 1.45. No cardiovascular pharmacotherapy was given at any stage of follow-up, which distinguishes this observation from previously published cases in which heart-failure-directed treatment was given concurrently.
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Baranov et al. (2026) conducted a case report in Anabolic-Androgenic Steroid-Associated Cardiomyopathy (n=1). Cessation of anabolic-androgenic steroids was evaluated on Regression of concentric left ventricular hypertrophy. Cessation of anabolic-androgenic steroids for eight years led to marked regression of left ventricular hypertrophy, with left ventricular mass index falling from 261 to 111 g/m2.
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