Sex-Steroid Hormones and Electrocardiographic QT-Interval Duration: Findings From the Third National Health and Nutrition Examination Survey and the Multi-Ethnic Study of Atherosclerosis

Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
American journal of epidemiology (Impact Factor: 5.23). 08/2011; 174(4):403-11. DOI: 10.1093/aje/kwr172
Source: PubMed


The association between physiologic levels of sex hormones and QT-interval duration in humans was evaluated using data from 727 men enrolled in the Third National Health and Nutrition Examination Survey and 2,942 men and 1,885 postmenopausal women enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA). Testosterone, estradiol, and sex hormone-binding globulin levels were measured in serum and free testosterone was calculated from those values. QT interval was measured using a standard 12-lead electrocardiogram. In men from the Third National Health and Nutrition Survey, the multivariate adjusted differences in average QT-interval duration comparing the highest quartiles with the lowest quartiles of total testosterone and free testosterone were -8.5 ms (95% confidence interval (CI): -15.5, -1.4) and -8.0 ms (95% CI: -13.2, -2.8), respectively. The corresponding differences were -1.8 ms (95% CI: -3.8, -0.2), and -4.7 ms (95% CI: -6.7, -2.6), respectively, in men from MESA and -0.6 ms (95% CI: -3.0, 1.8) and 0.8 ms (95% CI: -1.6, 3.3), respectively, in postmenopausal women from MESA. Estradiol levels were not associated with QT-interval duration in men, but there was a marginally significant positive association in postmenopausal women. The findings suggest that testosterone levels may explain differences in QT-interval duration between men and women and could be a contributor to population variability in QT-interval duration among men.

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Available from: Elsayed Z Soliman, Feb 01, 2014
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    • "The sex difference is thought to be caused by shortening of the action potential by endogenous testosterone and progesterone, which is supported by many clinical and basic studies (Kurokawa et al., 2012, 2009; Zhang et al., 2011; Charbit et al., 2009; Pecori Giraldi et al., 2010). Instead, estrogen has both antiarrhythmic and arrhythmic effects. "
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