Women with congenital adrenal hyperplasia had a significantly shorter QTcF interval compared to healthy women (404 vs 413 milliseconds; P<=0.001), with no significant difference observed in men.
Case-Control (n=168)
Do sex steroid hormones and gonadotropins influence QT interval duration in healthy subjects and patients with congenital adrenal hyperplasia?
The progesterone/estradiol ratio in women, testosterone in men, and FSH in both genders are major determinants of ventricular repolarization, helping to explain gender differences in QT interval duration.
Tasa de eventos absoluta: 404% vs 413%
valor p: p=<= .001
CONTEXT: QT interval duration is longer in women than in men. Sex steroid hormones have inconsistently been suggested to explain this difference. The implication of gonadotropins has never been studied. OBJECTIVE: We report here the combined influence of sex steroid hormones and gonadotropins on QT interval duration in healthy subjects and patients with congenital adrenal hyperplasia (CAH) as a model of T and progesterone overexpression. DESIGN AND PATIENTS: Eighty-four CAH patients (58 women) and 84 healthy subjects matched and paired for sex and age were prospectively included. Circulating concentrations of 17-OH-progesterone, progesterone, T, estradiol, FSH, and LH were measured concomitantly to the recording of a digitized electrocardiogram. RESULTS: QTcFridericia (QTcF) was shorter in women with CAH than in control women (404 ± 2 vs 413 ± 2.1 milliseconds; P ≤ .001). 17-OH-progesterone, progesterone, the progesterone/estradiol ratio, and total T were higher in women with CAH than in female controls (P < .05), whereas FSH was lower (P ≤ .05). According to multivariable analysis in all women, the progesterone/estradiol ratio (β = -0.33) and FSH levels (β = 0.34) were related to QTcF (r = 0.5; P < .0001), with no influence of CAH or healthy status. QTcF was not different between CAH (404.7 ± 3.7 milliseconds) or healthy men (396 ± 2.8 milliseconds). For men, QTcF (r = 0.48; P < .01) was negatively related to free T (β = -0.29) and positively to FSH levels (β = 0.34). CONCLUSION: Cardiac repolarization is influenced by complex interactions between sex steroid hormones and gonadotropins, depending on gender. Our results indicate that the progesterone/estradiol ratio in women, T in men, and FSH in both genders are major determinants of ventricular repolarization with opposite effects on QTc interval.
Abehsira et al. (Wed,) conducted a case-control in Congenital adrenal hyperplasia (n=168). Congenital adrenal hyperplasia (CAH) vs. Healthy subjects was evaluated on QTcFridericia (QTcF) duration in women (p=<= .001). Women with congenital adrenal hyperplasia had a significantly shorter QTcF interval compared to healthy women (404 vs 413 milliseconds; P<=0.001), with no significant difference observed in men.