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QTc Interval: Gender Difference and effect of Menstrual Cycle
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Context: Women are more predisposed to ventricular arrhythmias than men. The occurrence of Torsades-de-pointes is increased with the degree of QT interval prolongation, and female gender is a known risk factor for its occurrence. Drug induced QT prolongation are greater in women than in men. Sex hormones have potential role on the mechanisms involved in the cardiac repolarization
Aims: To note gender difference and menstrual cycle effect on cardiac electrophysiology
Settings and Design: Case-control study
Method and Material: Electrocardiogram (ECG) was recorded in randomly selected healthy 51 men and 51 women; aged between 17-20 yrs. ECG in women was taken during menstrual, proliferative and luteal phases of menstrual cycle. Basal body temperature throughout menstrual cycle was recorded in women to confirm that recordings were done in respective 3 phases of menstrual cycle. RR interval, QT interval and QTc interval were noted from Lead II recording of the subjects.
Statistical analysis used: Student's unpaired T test, Repeated measures ANOVA
Results: Study group was age matched. There was statistically highly significant gender difference during menstrual phase (p<0.001) and proliferative phase (p<0.001), and significant difference during secretory phase (p=0.008). Difference in mean QTc interval in women during different phases of menstrual cycle is statistically not significant (p=0.08).
Conclusions: There is gender difference in QTc interval of cardiac repolarization. There is no statistically significant difference in QTc interval in women during different phases of menstrual cycle. This difference is higher during menstrual phase in women
Keywords
- Grilo LS, Abriel H. Male and female equality: still far from goal. J Physiol 2008; 586(12): 2825-6.
- Lehmann MH, Hardy S, Archibald D, Quart B, MacNeil DJ. Sex difference in risk of torsade de pointes with d,l-sotalol. Circulation 1996; 94(10): 2535–41.
- Drici MD, Knollmann BC, Wang WX, Woosley RL. Cardiac actions of erythromycin: influence of female sex. JAMA 1998; 280(20): 1774–6.
- De´molis JL, Charransol A, Funck-Brentano C, Jaillon P. Effects of a single oral dose of sparfloxacin on ventricular repolarization in healthy volunteers. Br J Clin Pharmacol 1996; 41: 499–503.
- De´molis JL, Kubitza D, Tenneze´ L, Funck- Brentano C. Effect of a single oral dose of moxifloxacin (400 mg and 800 mg) on ventricular repolarization in healthy subjects. Clin Pharmacol Ther 2000; 68: 658–66.
- Drici MD, Wang WX, Liu XK, Woosley RL, Flockhart DA. Prolongation of QT interval in isolated feline hearts by antipsychotic drugs. J Clin Psychopharmacol 1998; 18(6): 477-81.
- Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH. Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. JAMA 1993; 270: 2590–7.
- Lehmann MH, Timothy KW, Frankovich D, Fromm BS, Keating M, Locati EH, et al. J Am Coll Cardiol 1997; 29: 93-9.
- Bazett H. An analysis of time-relations of electrocardiograms. Heart 1920; 7: 353-70.
- Surawicz B, Parikh SR. Prevalence of male and female patterns of early ventricular repolarization in the normal ECG of males and females from childhood to old age. J Am Coll Cardiol 2002; 40: 1870-1876.
- Moss AJ. Gender differences in ECG parameters and their clinical implications. Ann Noninvasive Electrocardiol 2010; 15(1): 1-2.
- Pham TV, Rosen MR. Sex, hormones, and repolarization. Cardiovascular Research 2002; 53: 740-751.
- Rodriguez I, Kilborn MJ, Liu XK, Pezzullo JC, Woosley RL. Drug-induced QT prolongation in women during the menstrual cycle. JAMA 2001; 285(10): 1322-1326.
- Burke JH, Goldberger JJ, Ehlert FA, Kruse JT, Parker MA, Kadish AH. Gender differences in heart rate before after autonomic blockade: evidence against an intrinsic gender effect. Am J Med 1996; 100: 537-543.
- McGill HCJ, Anselmo VC, Buchanan JM, Sheridan PJ. The heart is a target organ for androgen. Science 1980; 207: 775-777.
- McGill HCJ, Sheridan PJ. Nuclear uptake of sex steroid hormones in the cardiovascular system of the baboon. Circ Res 1981; 48: 238-44.
- Pham TV, Robinson RB, Danilo PJ, Rosen MR. Effects of gonadal steroids on gender-related differences in transmural dispersion of L-type calcium current. Cardiovasc Res 2002; 53(3): 752-762.
- Pragnell M, Snay KJ, Trimmer JS, MacLusky NJ, Naftolin F, Kaczmarek LK, et al. Estrogen induction of a small, putative K+ channel mRNA in rat uterus. Neuron 1990; 4(5): 807-812.
- Drici MD, Burklow TR, Haridasse V, Glazer RI, Woosley RL. Sex hormones prolong the QT interval and downregulate potassium channel expression in the rabbit heart. Circulation 1996; 94: 1471-1474.
- Hara M, Danilo PJ, Rosen MR. Effects of gonadal steroids on ventricular repolarization and on the response to E4031. J Pharmacol Exp Ther 1998; 285: 1068-1072.
- Jonsson MK, Vos MA, Duker G, Demolombe S, van Veen TA. Gender disparity in cardiac electrophysiology: implications for cardiac safety pharmacology. Pharmacol Ther 2010; 127(1): 9-18.
- Johnson BD, Zheng W, Korach KS, Scheuer T, Catterall WA, Rubanyi GM. Increased expression of the cardiac L-type calcium channel in estrogen receptor-def icient mice. J Gen Physiol 1997; 110(2): 135-140.
- Kannankeril PJ, Roden DM. Drug-induced long QT and torsade de pointes: recent advances. Curr Opin Cardiol 2007; 22(1): 39-43.
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