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Hipogonad erkek hastalarda testosteron tedavisinin QT dispersiyonu üzerine erken dönem etkisi

The effect of testosterone therapy on QT dispersion in patients with secondary hypogonadism

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Abstract (2. Language): 
Compared to female sex, QT dispersion as a reflection of ventricular depolarization heterogeneity is shorter in males. In this study, we aimed to delineate QT dispersion changes in secondary hypogonadism patients with testosterone replacement therapy. Fifteen male patients with a diagnosis of secondary hypogonadism comprised the study group. We selected 15 age-matched male volunteers without any clinical evidence or history of disease as a control group. After obtaining baseline ECG from all subjects, QT and-QTc dispersion values were calculated. In hypogonadal patients, repeat ECG and subsequent QTQTc dispersion measurements were made at the 10th day of testosterone therapy. Although statistically not significant, QT and QTc dispersion values were longer in patients with hypogonadism compared to healthy subjects (45±18 msec vs 36±12 p>0.05 msec and 58±23 mec vs 50±17 msec p>0.05, respectively). We detected statistically significant decrease in QT and QTc dispersion values at the 10th day of testosterone therapy in hypogonadal patients (45±18 msn vs 31±13 msn, p=0.01 and 58±23 msec vs 39±16 msec). QT dispersion shortening and potential stabilization of ventricular repolarization heterogeneity secondary to testosterone therapy in male patients with secondary hypogonadism might have important clinical implications such as arrhythmic risk reduction. This requires further prospective and large-scale studies.
Abstract (Original Language): 
Kadınlarla karşılaştırıldığında, erkeklerde kardiyak repolarizasyon süresi daha kısadır. QT dispersiyonu, ventriküler repolarizasyonun heterojenitesini gösteren önemli bir parametredir. Bu çalışmada, hipogonad erkek hastalarda testosteron replasman tedavisinin QT dispersiyonu üzerine etkisi araştırıldı. Çalışmaya sekonder hipogonodotropik hipogonadizm tanısı almış 15 hasta alındı. Daha önceden hastalık öyküsü bulunmayan ve fizik muayene, EKG testleri ile sağlıklı olduğuna karar verilen 15 erkek hasta ise kontrol grubunu oluşturdu. Çalışma ve kontrol grubunda başlangıç EKG kayıtlarından QT dispersi-yonu ölçülmesinden sonra çalışma grubundaki hastalarda testosteron tedavisi verilmesinin 10. gününde QT dispersiyon ölçümü tekrar edildi. Testosteron tedavisi öncesinde sağlıklı bireylerle karşılaştırıldığında hipogonad hastalarda QT ve QTc dispersiyonu değerlerinin anlamlı seviyeye ulaşmasa da daha uzun olduğu bulundu (sırası ile 45±18 msn'e karşın 36±12 msn, p>0.05 ve 58±23 msn'e karşın 50±17 msn, p>0.05). Testosteron tedavisi ile bu hastalarda erken dönemde QT ve QTc dispersiyonunun anlamlı derecede azaldığı tespit edildi (QT dispersiyonu 45±18 msn'den 31±13 msn değerine, p=0.005; QTc dispersiyonu 58±23 msn'- den 39±16 msn değerine, p=0.01). QT dispersiyonunda testosteron tedavisi ile anlamlı derecede kısalmanın sağlanması repolarizasyonun heterojenliğinin azaltılması yolu ile aritmi gelişiminde etkili olabilir, ancak hipogonad erkeklerde aritmi riskinin değerlendirilmesi, prospektif ve daha büyük ölçekli çalışmaları gerektirmektedir.
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