Abstract
Background and Objectives: The effects of gender differences on cardiac parameters have been well-established. In this study, we aimed to evaluate the possible associations of plasma levels of different sex hormones with premature atrial or ventricular contractions in premenopausal women. Materials and Methods: We conducted a prospective study which included women in late reproductive age who presented with palpitations during an eight-month period. A 12-lead electrocardiography, a transthoracic echocardiogram, blood samples, and 24-hour rhythm Holter were conducted on the third day of the menstrual cycle. Results Overall, 93 healthy premenopausal women with a median age of 42 years were enrolled. QTc interval was within normal limits in all patients. The 24 h range of premature atrial contractions (PACs) and premature ventricular contractions (PVCs) was 0–6450 and was 0–21,230, respectively. The median number of PVCs was 540 and the median number of PACs was 212, respectively. In total, 51 patients (54.8%) had a frequency of PVCs > 500/24 h and 37 patients (39.8%) had a frequency of PACs > 500/24 h, respectively. No statistically significant association was shown between any hormone and the frequency of PACs. Regarding PVCs, patients with a PVCs frequency > 500/24 h had higher estradiol levels compared to patients with PVCs less than 500/24 h (median 60 pg/mL versus 42 pg/mL, p = 0.02, OR: 1.01). No association was found between PVCs and other hormones. Conclusions: In premenopausal healthy women, higher estradiol levels are independently associated with increased PVCs. This suggests that estradiol in late reproductive stages may exert proarrhythmic effects.
Highlights
Gender differences in the incidence of cardiac arrhythmias have been well documented [1]
After a 10-minute resting period, a 12-lead resting electrocardiogram (ECG) (Marquette Mac 5500, GE Healthcare Bio-Sciences, Pittsburgh, PA, USA) was conducted at 50 mm/s and 20 mm/mV voltage in a supine position and revealed sinus rhythm with PR, QRS and heart rate-corrected QT intervals being within normal ranges
This study revealed that, in the early stage of the follicular phase of the menstrual cycle, a positive association between E2 levels and premature ventricular contractions (PVCs) frequency was determined to exist
Summary
Gender differences in the incidence of cardiac arrhythmias have been well documented [1]. Many studies have been conducted about the effect on sex hormones on QT interval duration, with E2 being generally considered to promote QTc lengthening and progesterone exerting the opposite action, results have been inconclusive; on the contrary, little data is available about the effects of these hormones on specific arrythmias, such as premature ventricular contractions (PVCs) or premature atrial contractions (PACs) [5]. We aimed to investigate the possible association of different hormones with the frequency of PVCs or PACs in heathy premenopausal women who presented with palpitations. We aimed to evaluate the possible associations of plasma levels of different sex hormones with premature atrial or ventricular contractions in premenopausal women
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