open access

Vol 76, No 6 (2018)
Original articles
Published online: 2018-01-26
Submitted: 2017-04-03
Accepted: 2017-12-19
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The effects of supraphysiological oestrogen levels on ventricular repolarisation parameters

Omer Yiginer, Mehmet Dogan, Ismet Gun, Huseyin Tayfun Kutlu, Gokhan Degirmencioglu, İlkin Guliyev, Alptug Tokatli, Fethi Kilicaslan
DOI: 10.5603/KP.a2018.0037
·
Kardiol Pol 2018;76(6):974-979.

open access

Vol 76, No 6 (2018)
Original articles
Published online: 2018-01-26
Submitted: 2017-04-03
Accepted: 2017-12-19

Abstract

Background: The frequency of arrhythmic death developing without a structural cardiac disease is higher in women. Also, female sex is an independent risk factor regarding development of torsades de pointes. Several studies have been conducted on the physiological and therapeutic effects of sex hormones on the cardiac conduction system.

Aim: In this study we aim to examine the effect of hormonal changes, especially supraphysiological E2 level changes occurring during in vitro fertilisation treatment, on ventricular repolarisation parameters.

Methods: The study included female patients aged between 23 and 39 years, who were administered controlled ovarian hyperstimulation treatment. Patients’ electrocardiograms and blood samples were obtained and analysed before and after the ovarian hyperstimulation treatment.

Results: Mean QTc intervals before ovarian hyperstimulation were 411.9 ± 23.7 ms. Measurements during oestradiol peak were calculated as 420.7 ± 23.3 ms, and the QTc interval increase was significant (p = 0.007). Corrected QT dispersion averages were not significant before or after hyperstimulation (53 ± 17 ms vs. 54.5 ± 18.2 ms, respectively, p > 0.05). Tp-e, J-T peak, and PR dispersion changes were not significant after the ovarian hyperstimulation therapy.

Conclusions: Supraphysiological oestradiol levels that occur during controlled ovarian hyperstimulation cause prolongation of QTc intervals, but not to a pathological level. Although this prolongation is not significant in healthy individuals, it might increase ventricular arrhythmia risk in patients with congenital long QT syndrome and in patients taking medication that prolongs QT.

Abstract

Background: The frequency of arrhythmic death developing without a structural cardiac disease is higher in women. Also, female sex is an independent risk factor regarding development of torsades de pointes. Several studies have been conducted on the physiological and therapeutic effects of sex hormones on the cardiac conduction system.

Aim: In this study we aim to examine the effect of hormonal changes, especially supraphysiological E2 level changes occurring during in vitro fertilisation treatment, on ventricular repolarisation parameters.

Methods: The study included female patients aged between 23 and 39 years, who were administered controlled ovarian hyperstimulation treatment. Patients’ electrocardiograms and blood samples were obtained and analysed before and after the ovarian hyperstimulation treatment.

Results: Mean QTc intervals before ovarian hyperstimulation were 411.9 ± 23.7 ms. Measurements during oestradiol peak were calculated as 420.7 ± 23.3 ms, and the QTc interval increase was significant (p = 0.007). Corrected QT dispersion averages were not significant before or after hyperstimulation (53 ± 17 ms vs. 54.5 ± 18.2 ms, respectively, p > 0.05). Tp-e, J-T peak, and PR dispersion changes were not significant after the ovarian hyperstimulation therapy.

Conclusions: Supraphysiological oestradiol levels that occur during controlled ovarian hyperstimulation cause prolongation of QTc intervals, but not to a pathological level. Although this prolongation is not significant in healthy individuals, it might increase ventricular arrhythmia risk in patients with congenital long QT syndrome and in patients taking medication that prolongs QT.

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Keywords

oestrogen, QT interval, QT dispersion, ventricular repolarisation, ovulation induction, in vitro fertilisation

About this article
Title

The effects of supraphysiological oestrogen levels on ventricular repolarisation parameters

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 76, No 6 (2018)

Pages

974-979

Published online

2018-01-26

DOI

10.5603/KP.a2018.0037

Bibliographic record

Kardiol Pol 2018;76(6):974-979.

Keywords

oestrogen
QT interval
QT dispersion
ventricular repolarisation
ovulation induction
in vitro fertilisation

Authors

Omer Yiginer
Mehmet Dogan
Ismet Gun
Huseyin Tayfun Kutlu
Gokhan Degirmencioglu
İlkin Guliyev
Alptug Tokatli
Fethi Kilicaslan

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