Departamento de Cardiología, Laboratorio de Arritmias, Hospital Ángeles Pedregal, Ciudad de México, México.
Departamento de Cardiología, Kingston Health Science Center, Queen's University, Kingston, Canada.
Arch Cardiol Mex. 2023;93(Supl):18-22. doi: 10.24875/ACM.M23000089.
The need to improve access to health services for the transgender community has become evident, especially concerning cardiovascular risk, which is higher compared to the general population. Surgical procedures and hormone therapies are common in this population to affirm gender identity, but they pose challenges as they are associated with disruptions in lipid metabolism, body fat concentration, and insulin resistance. Additionally, there is an increased risk of adverse cardiovascular events such as venous thromboembolism, stroke, and myocardial infarction. The influence of sex hormones on the electrophysiological properties of the heart has been studied, highlighting gender differences that may predispose the transgender population to cardiac arrhythmias. Exogenous hormone therapy, for both transgender women and men, can affect the QT interval and increase the risk of arrhythmias, including atrial fibrillation. Although the incidence of arrhythmias in the transgender population is not entirely clear, evidence suggests the need for careful cardiovascular monitoring and consideration of risk factors before initiating hormone therapies.
提高跨性别群体获得医疗服务的机会的需求已经变得明显，特别是在心血管风险方面，与普通人群相比，跨性别群体的风险更高。手术程序和激素疗法在这个群体中很常见，以确认其性别认同，但它们带来了挑战，因为它们与脂质代谢、体脂肪浓度和胰岛素抵抗的紊乱有关。此外，还存在静脉血栓栓塞、中风和心肌梗死等不良心血管事件的风险增加。已经研究了性激素对心脏电生理特性的影响，突出了性别差异，这些差异可能使跨性别群体容易发生心律失常。外源性激素治疗，无论是对跨性别女性还是男性，都可能影响 QT 间期并增加心律失常的风险，包括心房颤动。尽管跨性别群体中心律失常的发生率尚不完全清楚，但有证据表明，在开始激素治疗之前，需要仔细进行心血管监测并考虑风险因素。
