TY  - JOUR
T1  - The impact of testosterone levels on J-wave patterns observed in healthy Turkish males
AU  - Hünük, Burak
PY  - 2020
DA  - September
Y2  - 2019
DO  - 10.18621/eurj.519192
JF  - The European Research Journal
JO  - Eur Res J
PB  - Prusa Medical Publishing
WT  - DergiPark
SN  - 2149-3189
SP  - 438
EP  - 448
VL  - 6
IS  - 5
LA  - en
AB  - Objectives:Early-repolarization(ER) and Brugada-type-ECG-patterns (BTEP) have recently been grouped under acommon terminology called “J-wave patterns” (JWP) and have been associated withan increased risk of sudden-cardiac-death. Scarce data is present about themale dominance in JWP and the probable effects of gonadal hormones on cardiacion-channel functions. We sought to evaluate the relationship oftestosterone-levels and the presence of JWP in healthy Turkish-males. Methods: One hundred eighty-five healthy male volunteers between ≥18to ≤50 years old without any cardiac disorders were evaluated. ECG, bloodbiochemistry and total testosterone levels were obtained together with thoroughphysical examination. Subjects with complete-bundle-branch-block,non-sinus-rhythms and any abnormality on cardiac examination were excluded fromthe study. BTEP was searched according to the EHRA/HRS 2016 ConsensusConference on V1-V3. ER on ECG was defined as J-point elevation of ≥ 0.1 mV in≥ 2 leads in the inferior (II, III, aVF) (Inferior ER), lateral (DI, aVL, V4-6)(Lateral ER) or both (Inferolateral ER). Results: A total of 179 subjects(mean age 34.9 ± 7.9 years) were included in our analyses. Three BTEP (1.7%)and 45 ER (26%) were detected. 22 were lateral (49%), 13 inferior (29%) and 10were (22%) inferolateral ER. JWP (+) subjects (n = 48, 27%) were demonstratingsignificantly lower basal heart rates (73.9 ± 11bpm vs 68.4 ± 10.3 bpm, p = 0.001) and longer PR intervals(153.9 ± 20.3 ms vs 163.3 ± 21.6 ms, p= 0.01). JWP (+) subjects had significantly higher testosterone levels comparedwith the ones without (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 withhigher testosterone levels compared with the JWP (-) population, whiletestosterone 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 presenceof a JWP on ECG was 629 ng/dl with a sensitivity of 44% and specificity of 86%[AUC = 0.66 (95% CI: 0.56-0.75),p = 0.001].In multivariate analysis, total testosterone level > 629 ng/dl wassignificantly predicting a JWP on ECG, even outperforming age and hs-CRP levelswith an OR of 4.57 (95% CI 1.910-10.9, p= 0.001). Conclusions: Testosteronemight be associated with the male predominance observed in the JWP. Moremalignant inferior/inferolateral ER seems to be mainly associated with the hightestosterone levels in Turkish male population. This finding might beattributed to the previously demonstrated effects of testosterone on cardiacion-channel functions, especially outward-K channels.
KW  - electrocardiogram
KW  - j wave pattern
KW  - male
KW  - testosterone
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UR  - https://doi.org/10.18621/eurj.519192
L1  - https://dergipark.org.tr/en/download/article-file/667230
ER  -