Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan.
Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Heart Rhythm. 2021 Jul;18(7):1203-1209. doi: 10.1016/j.hrthm.2021.03.009. Epub 2021 Mar 8.
Men and women have specific patterns in an electrocardiogram (ECG) differentiated by J-point elevation and ST-segment angle. Although gender-affirming hormone treatment is one of the treatments for gender dysphoria, its influence on an ECG has not been clarified yet.
The purpose of this study was to investigate ECG changes induced by gender-affirming hormone treatment.
The study population consisted of 29 transgender males and 8 transgender females and 37 age- and sex-matched cisgender females and males. Male pattern was defined as J-point elevation > 0.1 mV and ST-segment angle > 20° in precordial leads.
In the comparison between 29 transgender males and cisgender females, the prevalence of the male pattern (89.7% vs 6.9%; P < .001), prevalence of the early repolarization pattern (51.7% vs 17.2%; P = .01), J-point elevation (leads V-V), T-wave amplitudes (leads V-V), QRS amplitudes (leads II, III, V-V), and P-wave amplitudes (leads V-V) were significantly higher in transgender males. The prevalence of the male pattern was lower in transgender females than in cisgender males (25.0% vs 87.5%; P = .04). In the analysis of transgender males for whom ECGs were available before and after gender-affirming hormone treatment (n = 13), J-point elevation and T-wave amplitudes significantly increased after gender-affirming hormone treatment, leading to a higher prevalence of the male pattern (23.1% vs 92.3%; P < .001). The prevalence of the early repolarization pattern and QRS amplitudes also significantly increased after the treatment, but the augmentation of P-wave amplitudes was modest.
Gender-affirming hormone treatment for gender dysphoria is accompanied by a change in ECG phenotype toward affirming gender, in which change in androgen level may be involved.
男性和女性的心电图（ECG）存在差异，表现为 J 点抬高和 ST 段角度。尽管性别肯定激素治疗是性别焦虑症的治疗方法之一，但它对心电图的影响尚未明确。
本研究旨在探讨性别肯定激素治疗引起的心电图变化。
研究人群包括 29 名跨性别男性和 8 名跨性别女性以及 37 名年龄和性别匹配的顺性别女性和男性。男性模式定义为胸前导联 J 点抬高>0.1 mV 和 ST 段角度>20°。
在 29 名跨性别男性与顺性别女性的比较中，男性模式（89.7% vs 6.9%；P<0.001）、早期复极模式（51.7% vs 17.2%；P=0.01）、J 点抬高（导联 V-V）、T 波振幅（导联 V-V）、QRS 振幅（导联 II、III、V-V）和 P 波振幅（导联 V-V）的发生率在跨性别男性中显著更高。跨性别女性的男性模式发生率低于顺性别男性（25.0% vs 87.5%；P=0.04）。在接受性别肯定激素治疗的跨性别男性（n=13）中，对其治疗前后的心电图进行分析，结果显示，在接受性别肯定激素治疗后，J 点抬高和 T 波振幅显著增加，导致男性模式的发生率更高（23.1% vs 92.3%；P<0.001）。治疗后早期复极模式和 QRS 振幅也显著增加，但 P 波振幅的增加幅度较小。
性别焦虑症的性别肯定激素治疗伴随着心电图表型向肯定性别转变，其中雄激素水平的变化可能起作用。
