Erythropoietin doping as cause of sudden death in athletes: an experimental study

Aims: To evaluate the cardiovascular (CV) effects of rhEPO treatment in rats under chronic aerobic exercise and to assess the probable cause of sudden death in one rat. Protocol: Male Wistar rats: control - sedentary; rhEPO - 50 IU/Kg/3xwk; swimming (EX) -1 hr, 3x/wk; EX+EPO. Hematology, catecholamines and serotonin, redox status and inflammation, were assessed. One rat of EX+EPO group suffered a sudden death episode. Results: rhEPO treatment in trained rats promoted several markers of increased CV risk. The sudden death rat tissues presented: lungs without signs of drowning; brain with vascular congestion; LV hypertrpphy and deregulations of cardiac fibers, together with a "cardiac liver", suggesting the hypothesis of heart failure as cause of death. Conclusion: The sudden death of a EX+EPO rat, due to a cardiac episode, together with the increased CV risk profile, strongly suggest a high life risk associated to the continuous rhEPO doping. The anatomo-pathological studies were determinant to establish the cause of death