Buradasınız

Anasayfa » Content

Hipogonad erkek hastalarda testosteron tedavisinin QT dispersiyonu üzerine erken dönem etkisi

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

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author Name
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.
Bookmark/Search this post with
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.
FULL TEXT (PDF): 
PDF icon arastirmax-hipogonad-erkek-hastalarda-testosteron-tedavisinin-qt-dispersiyonu-uzerine-erken-donem-etkisi.pdf
  • 1
22-24
  • Turkish

REFERENCES

References: 

1. Day CP, McComb JM, Campbell RWF.
QT dispersion: an indication of arrhythmia
risk in patients with long QT intervals. Br
Heart J 1990; 63: 342-344.
2. Macfarlane PW, McLaughlin SC, Rodger
JC. Influence of lead selection and population on automated measurement of QT
dispersion. Circulation 1998; 98: 2160-
2167.
3. Tran H, White CM, Chow MS, Kluger J.
An evaluation of the impact of gender and
age on QT dispersion in healthy subjects.
Ann Noninvasive Electrocardiol 2001; 6:
129-133.
4. Malik M, Batchvarov VN. Measurement,
interpretation and clinical potential of QT
dispersion. J Am Coll Cardiol 2000; 36:
1749-1766.
5. White CM, Ferraro-Borgida MJ, Moyna
NM, et al. The effect of pharmacokinetically guided acute intravenous testosterone
administration on electrocardiographic and
blood pressure variables. J Clin Pharmacol
1999; 39: 1038-1043.
6. Miorelli M, Buja G, Melacini P, Fasoli G,
Nava A. QT-interval variability in hypertrophic cardiomyopathy patients with cardiac arrest. Int J Cardiol 1994; 45: 121-127.
7. Davey PP, Bateman J, Mulligan IP, Forfar
C, Barlow C, Hart G. QT interval dispersion in chronic heart failure and left ventricular hyperthrophy; relation to autonomic nervous system and Holter tape
abnormalities. Br Heart J 1994; 71: 268-
273.
8. Taneja T, Larsen J, Goldberger J, Kadish A.
Age, gender, and autonomic tone effects on
surface electrocardiographic indices of ventricular repolarization. Ann Noninvasive
Electrocardiol 2001; 6: 290-297.
9. Pham TV, Rosen MR. Sex, hormones, and
repolarization. Cardiovasc Res 2002; 53:
740-751.
10. Wolbrette D. Gender differences in the
proarrhythmic potential of QT-prolonging
drugs. Current Womens Health Reports
2002; 2: 105-109.
11. Rautaharju PM, Zhou SH, Wong S, et al.
Sex differences in the evolution of the electrocardiographic QT interval with age. Can
J Cardiol 1992; 8: 690-695.
12. Bidoggia H, Maciel J, Capalozza N, et al.
Sex differences on the electrocardiographic
pattern of cardiac repolarization: possible
role of testosterone. Am Heart J 2000; 140:
678-683.
13. Kirilmaz A, Bolu E, Kilicaslan F, et al.
Comparison of electrocardiographic repolarization patterns between hypogonad
males and normal subjects. Ann
Noninvasive Electrocardiol 2003; 8: 284-
288.
14. Surawichz 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.
15. Liu XK, Katchman A, Drici MD, et al.
Gender difference in the cycle lengthdependent QT and potassium currents in
rabbits. J Pharmacol Exp Ther 1998; 285:
672-679.
16. Pham TV, Rosen MR. Sex, hormones, and
repolarization. Cardiovasc Res 2002; 53:
740-751.
17. Yang H, Elko P, Fromm BS, et al. Maximal
ascending and descending slopes of the T
wave in men and women. J Electrocardiol
1997; 30: 267-276.
18. Malik M, Camm AJ. Mystery of QTc interval dispersion. Am J Cardiol 1997; 79: 785-
787.
19. Lee KW, Kligfield P, Dower GE, Okin PM.
QT dispersion, T wave projection, and heterogeneity of repolarization in patients with
coronary artery disease. Am J Cardiol 2001;
87: 148-151.
20. Somberg JC, Molnar J. Usefulness of QT
dispersion as an electrocardiographically
derived index. Am J Cardiol. 2002; 89: 291-
294.

Thank you for copying data from http://www.arastirmax.com