Women's Heart Center, Division of Cardiology, Department of Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 444 S. San Vicente Boulevard, Los Angeles, CA 90048, USA.
J Womens Health (Larchmt). 2012 Sep;21(9):933-41. doi: 10.1089/jwh.2011.3444. Epub 2012 Jun 4.
A prolonged QT interval is a marker for an increased risk of ventricular tachyarrhythmias. Both endogenous and exogenous sex hormones have been shown to affect the QT interval. Endogenous testosterone and progesterone shorten the action potential, and estrogen lengthens the QT interval. During a single menstrual cycle, progesterone levels, but not estrogen levels, have the dominant effect on ventricular repolarization in women. Studies of menopausal hormone therapy (MHT) in the form of estrogen-alone therapy (ET) and estrogen plus progesterone therapy (EPT) have suggested a counterbalancing effect of exogenous estrogen and progesterone on the QT. Specifically, ET lengthens the QT, whereas EPT has no effect. To date, there are no studies on oral contraception (OC) and the QT interval, and future research is needed. This review outlines the current literature on sex hormones and QT interval, including the endogenous effects of estrogen, progesterone, and testosterone and the exogenous effects of estrogen and progesterone therapy in the forms of MHT and hormone contraception. Further, we review the potential mechanisms and pathophysiology of sex hormones on the QT interval.
QT 间期延长是室性心律失常风险增加的标志。内源性和外源性性激素都被证明会影响 QT 间期。内源性睾酮和孕酮缩短动作电位，而雌激素延长 QT 间期。在一个月经周期中，孕激素水平而非雌激素水平对女性心室复极有主导作用。单独使用雌激素治疗（ET）和雌激素加孕激素治疗（EPT）形式的绝经激素治疗（MHT）的研究表明，外源性雌激素和孕激素对 QT 有平衡作用。具体来说，ET 延长 QT，而 EPT 没有影响。迄今为止，尚无关于口服避孕药（OC）和 QT 间期的研究，需要开展进一步的研究。本综述概述了目前关于性激素和 QT 间期的文献，包括雌激素、孕酮和睾酮的内源性作用，以及 MHT 和激素避孕中雌激素和孕激素治疗的外源性作用。此外，我们还回顾了性激素对 QT 间期的潜在机制和病理生理学。
