Why the study?
Sex influences cardiac pro-arrhythmic disorders through QT interval effects, with androgens shortening QT to protect against acquired long QT syndromes while potentially potentiating Brugada and early repolarization syndromes.
Case Report (n=4)
Androgens have a double-edged effect on ventricular repolarization, where both deprivation and exogenous supplementation can lead to life-threatening arrhythmias, highlighting the need for QTc monitoring.
Case reports of aborted SCD in men highlight androgen effects on Brugada syndrome; hypothesis-generating and should not change practice.
The prevalence and incidence of cardiac pro-arrhythmic disorders are often influenced by sex due to specific effects on the QT interval. Androgens shorten QT, which may be protective against acquired long QT syndromes and their related arrhythmias in men such as torsade de pointes (TdP). On the other hand, androgens can potentiate Brugada and early repolarization syndromes, which are most prevalent in men. In this case series, we highlight four male patients with aborted SCD in the setting of abnormal testosterone status; two patients with TdP in a setting of testosterone deprivation (of which one drug-induced) and 2 patients with ventricular fibrillation associated with exogenous androgenic booster (Tribulus terrestris) intake. From this case series, we review the current available literature of the effects of androgen as a double-edged sword on the QTc interval and emphasize the importance of QTc monitoring in this subset of patients.
No takes yet. Share an insight, caveat, or question.
Moey et al. (2021) conducted a case report in Aborted sudden cardiac death with abnormal testosterone status (n=4). Abnormal testosterone status (deprivation or exogenous androgenic booster) was evaluated on Aborted sudden cardiac death (Torsade de pointes or ventricular fibrillation).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: