The impact of testosterone levels on J-wave patterns observed in healthy Turkish males

Yıl 2020, Cilt: 6 Sayı: 5, 438 - 448, 04.09.2020

Burak Hünük

https://doi.org/10.18621/eurj.519192

Cited By: 2

Öz

Objectives:
Early-repolarization
(ER) and Brugada-type-ECG-patterns (BTEP) have recently been grouped under a
common terminology called “J-wave patterns” (JWP) and have been associated with
an increased risk of sudden-cardiac-death. Scarce data is present about the
male dominance in JWP and the probable effects of gonadal hormones on cardiac
ion-channel functions. We sought to evaluate the relationship of
testosterone-levels and the presence of JWP in healthy Turkish-males.

Methods: One hundred eighty-five healthy male volunteers between ≥18
to ≤50 years old without any cardiac disorders were evaluated. ECG, blood
biochemistry and total testosterone levels were obtained together with thorough
physical examination. Subjects with complete-bundle-branch-block,
non-sinus-rhythms and any abnormality on cardiac examination were excluded from
the study. BTEP was searched according to the EHRA/HRS 2016 Consensus
Conference on V1-V3. ER on ECG was defined as J-point elevation of ≥ 0.1 mV in
≥ 2 leads in the inferior (II, III, aVF) (Inferior ER), lateral (DI, aVL, V4-6)
(Lateral ER) or both (Inferolateral ER).

Results: A total of 179 subjects
(mean age 34.9 ± 7.9 years) were included in our analyses. Three BTEP (1.7%)
and 45 ER (26%) were detected. 22 were lateral (49%), 13 inferior (29%) and 10
were (22%) inferolateral ER. JWP (+) subjects (n = 48, 27%) were demonstrating
significantly lower basal heart rates (73.9 ± 11bpm vs 68.4 ± 10.3 bpm, p = 0.001) and longer PR intervals
(153.9 ± 20.3 ms vs 163.3 ± 21.6 ms, p
= 0.01). JWP (+) subjects had significantly higher testosterone levels compared
with the ones without (485.5 ± 128.3 ng/dl vs 559.3 ± 167.7, p < 0.001). In the subgroup analyses,
BTEP and inferior/inferolateral ER patterns were significantly associated with
higher testosterone levels compared with the JWP (-) population, while
testosterone levels of subjects with lateral ER was not significantly higher.
Electrolytes and blood chemistry values were non-significant between JWP + and
- subjects. In the ROC analysis, the cut-off value for predicting the presence
of a JWP on ECG was 629 ng/dl with a sensitivity of 44% and specificity of 86%
[AUC = 0.66 (95% CI: 0.56-0.75), p = 0.001].
In multivariate analysis, total testosterone level > 629 ng/dl was
significantly predicting a JWP on ECG, even outperforming age and hs-CRP levels
with an OR of 4.57 (95% CI 1.910-10.9, p
= 0.001).

Conclusions: Testosterone
might be associated with the male predominance observed in the JWP. More
malignant inferior/inferolateral ER seems to be mainly associated with the high
testosterone levels in Turkish male population. This finding might be
attributed to the previously demonstrated effects of testosterone on cardiac
ion-channel functions, especially outward-K channels. 

Anahtar Kelimeler

electrocardiogram, j wave pattern, male, testosterone

Kaynakça

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