SERUM ESTRADIOL TO TESTOSTERONE RATIO AS A PREDICTOR OF DRUG-INDUCED QT INTERVAL PROLONGATION IN MALE PATIENTS

  • Authors: Kalatsei L.V.1
  • Affiliations:
    1. Grodno State Medical University
  • Issue: Vol 11, No 1 (2022): XVI МЕЖДУНАРОДНАЯ НАУЧНО-ПРАКТИЧЕСКАЯ КОНФЕРЕНЦИЯ МОЛОДЫХ УЧЕНЫХ-МЕДИКОВ
  • Pages: 21-22
  • Section: Результаты фундаментальных и прикладных исследований
  • URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/7504

Cite item

Abstract

Aim. To establish the prognostic value of the serum estradiol to testosterone (E/T) ratio for the development of drug-induced long QT syndrome (LQTS).

Materials and methods. 59 male patients were examined, mainly with ischemic heart disease, hypertension and cardiac arrhythmias, 29 (49.2%) of them with drug-induced LQTS and 30 (50.8%) with normal values ​​of the QT interval while receiving antiarrhythmic therapy.

Results. Patients with drug-induced LQTS have higher E/T ratio values ​​compared to patients without LQTS (median 9.18 vs 4.72, p<0.001). An E/T ratio value ≥6.08 can be used to predict the development of drug-induced LQTS in male patients taking amiodarone and sotalol (OR=3.43 [95% CI 2.27; 5.19]).

Conclusion. Our data indicate the important physiological role of sex hormones, in particular, estradiol and testosterone, as well as their ratio in the genesis of drug-induced LQTS in male patients.

Full Text

Introduction. A decrease in serum testosterone and an increase in serum estradiol levels in men is associated with QT interval prolongation of the standard ECG due to changes in the work of potassium and calcium ion channels[1-2]. The scientific literature provides relatively little information on the prognostic value of the estradiol to testosterone (E/T) ratio on the development of drug-induced QT prolongation (LQTS) while taking class III antiarrhythmic drugs.

The aim of this study is to evaluate the E/T ratio in male patients with and without drug-induced LQTS while taking class III antiarrhythmic drugs and to establish the prognostic value of the E/T index for the development of drug-induced LQTS.

Materials and methods. To achieve this goal, 59 male patients were examined, mainly with ischemic heart disease, arterial hypertension and cardiac arrhythmias, of which 29 (49.2%) had drug-induced LQTS and 30 (50.8%) - with normal values ​​of the QT interval while taking antiarrhythmic therapy. All patients underwent clinical, laboratory and instrumental studies, including the determination of testosterone and estradiol in venous blood serum.

Results. The patients of the studied groups were comparable in age and clinical and nosological characteristics, as well as in the total number of drugs taken, including those with the risk of prolongation of the QT interval (p>0.05). We found that patients with drug-induced LQTS have higher values ​​of the E/T ratio compared to patients without LQTS (median 9.18 vs 4.72, p<0.001), especially in the middle and elderly age group in accordance with the WHO age classification (p=0.009).

The value of the E/T ratio ≥6.08 demonstrated high sensitivity (100%) and specificity (72.54%), as well as a fairly high area under the ROC-curve (0.852) and can be used to predict the development of drug-induced LQTS in male patients taking amiodarone and sotalol (OR=3.43 [95% CI 2.27; 5.19]).

Conclusion. Our data indicate the important physiological role of sex hormones, in particular, estradiol and testosterone, as well as their ratio in the genesis of drug-induced LQTS in male patients. Given the small size of the study sample, the applicability of this indicator needs to be tested on a larger group of patients.

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About the authors

Liudmila V. Kalatsei

Grodno State Medical University

Author for correspondence.
Email: lkolotsey@mail.ru
ORCID iD: 0000-0001-5211-709X
SPIN-code: 8435-3422

assistant, postgraduate student of the Department of Internal Medicine I

Belarus, 80 Gorkogo street, 230029 Grodno, Belarus

References

  1. Kittnar O. Selected sex related differences in pathophysiology of cardiovascular system // Physiol Res. 2020. №69. P. 21–31.
  2. Costa S., Saguner A.M., Gasperetti A., et al. The Link Between Sex Hormones and Susceptibility to Cardiac Arrhythmias: From Molecular Basis to Clinical Implications. Front Cardiovasc Med. 2021. №8. P. 64–79.

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