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

Authors : Burak HÜNÜK
Pages : 438-448
Doi:10.18621/eurj.519192
View : 30 | Download : 13
Publication Date : 2020-09-04
Article Type : Research Paper
Abstract :Objectives: Early-repolarization insert ignore into journalissuearticles values(ER); and Brugada-type-ECG-patterns insert ignore into journalissuearticles values(BTEP); have recently been grouped under a common terminology called “J-wave patterns” insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(II, III, aVF); insert ignore into journalissuearticles values(Inferior ER);, lateral insert ignore into journalissuearticles values(DI, aVL, V4-6); insert ignore into journalissuearticles values(Lateral ER); or both insert ignore into journalissuearticles values(Inferolateral ER);. Results: A total of 179 subjects insert ignore into journalissuearticles values(mean age 34.9 ± 7.9 years); were included in our analyses. Three BTEP insert ignore into journalissuearticles values(1.7%); and 45 ER insert ignore into journalissuearticles values(26%); were detected. 22 were lateral insert ignore into journalissuearticles values(49%);, 13 inferior insert ignore into journalissuearticles values(29%); and 10 were insert ignore into journalissuearticles values(22%); inferolateral ER. JWP insert ignore into journalissuearticles values(+); subjects insert ignore into journalissuearticles values(n = 48, 27%); were demonstrating significantly lower basal heart rates insert ignore into journalissuearticles values(73.9 ± 11bpm vs 68.4 ± 10.3 bpm, p = 0.001); and longer PR intervals insert ignore into journalissuearticles values(153.9 ± 20.3 ms vs 163.3 ± 21.6 ms, p = 0.01);. JWP insert ignore into journalissuearticles values(+); subjects had significantly higher testosterone levels compared with the ones without insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(-); 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 insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(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. 
Keywords : electrocardiogram, j wave pattern, male, testosterone

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