Gender Differences in Autonomic Modulation of Ventricular Repolarization in Humans
Background: Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more common in women than men. Although increased sympathetic tone has an important role in vulnerability to arrhythmia, little is currently know...
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Published in | Journal of cardiovascular electrophysiology Vol. 16; no. 3; pp. 278 - 284 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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Blackwell Science Inc
01.03.2005
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Abstract | Background: Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more common in women than men. Although increased sympathetic tone has an important role in vulnerability to arrhythmia, little is currently known regarding gender differences in the dynamic electrophysiological response to sympathetic stimulation. Therefore, we investigated whether there is a gender difference in humans with respect to the dynamic response of ventricular repolarization to β‐adrenergic stimulation and to autonomic blockade.
Methods: Twelve‐lead ECGs were continuously recorded during isoproterenol infusion (protocol 1) and autonomic blockade with propranolol and atropine infusion (protocol 2) in 24 healthy volunteers (12 men, 23 ± 2 years; 12 women, 23 ± 5 years). QT (QTc) intervals were measured at the baseline and at a heart rate of 75, 100, and 120 beats/min.
Results: (1) The morphology of the T wave dynamically and transiently changed to bifid or biphasic during the acute phase of isoproterenol infusion. The incidence of these morphologic changes was higher in women than men (P < 0.05). (2) The QTc interval was initially prolonged and then shortened in both men and women during isoproterenol administration. However, QTc prolongation was significantly greater in women (0.44 ± 0.02 to 0.55 ± 0.03 sec) than men (0.42 ± 0.03 to 0.51 ± 0.04 sec; P < 0.05). (3) The QTc interval was significantly prolonged under autonomic blockade and the intrinsic QTc interval was longer in women than men (P < 0.05).
Conclusion: While sympathetic stimulation and autonomic blockade modulated the dynamics of ventricular repolarization in both sexes, it was more pronounced in women. This gender difference may partially account for the susceptibility of women to arrhythmogenesis. |
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AbstractList | Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more common in women than men. Although increased sympathetic tone has an important role in vulnerability to arrhythmia, little is currently known regarding gender differences in the dynamic electrophysiological response to sympathetic stimulation. Therefore, we investigated whether there is a gender difference in humans with respect to the dynamic response of ventricular repolarization to beta-adrenergic stimulation and to autonomic blockade.
Twelve-lead ECGs were continuously recorded during isoproterenol infusion (protocol 1) and autonomic blockade with propranolol and atropine infusion (protocol 2) in 24 healthy volunteers (12 men, 23 +/- 2 years; 12 women, 23 +/- 5 years). QT (QTc) intervals were measured at the baseline and at a heart rate of 75, 100, and 120 beats/min.
(1) The morphology of the T wave dynamically and transiently changed to bifid or biphasic during the acute phase of isoproterenol infusion. The incidence of these morphologic changes was higher in women than men (P < 0.05). (2) The QTc interval was initially prolonged and then shortened in both men and women during isoproterenol administration. However, QTc prolongation was significantly greater in women (0.44 +/- 0.02 to 0.55 +/- 0.03 sec) than men (0.42 +/- 0.03 to 0.51 +/- 0.04 sec; P < 0.05). (3) The QTc interval was significantly prolonged under autonomic blockade and the intrinsic QTc interval was longer in women than men (P < 0.05).
While sympathetic stimulation and autonomic blockade modulated the dynamics of ventricular repolarization in both sexes, it was more pronounced in women. This gender difference may partially account for the susceptibility of women to arrhythmogenesis. Background: Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more common in women than men. Although increased sympathetic tone has an important role in vulnerability to arrhythmia, little is currently known regarding gender differences in the dynamic electrophysiological response to sympathetic stimulation. Therefore, we investigated whether there is a gender difference in humans with respect to the dynamic response of ventricular repolarization to β‐adrenergic stimulation and to autonomic blockade. Methods: Twelve‐lead ECGs were continuously recorded during isoproterenol infusion (protocol 1) and autonomic blockade with propranolol and atropine infusion (protocol 2) in 24 healthy volunteers (12 men, 23 ± 2 years; 12 women, 23 ± 5 years). QT (QTc) intervals were measured at the baseline and at a heart rate of 75, 100, and 120 beats/min. Results: (1) The morphology of the T wave dynamically and transiently changed to bifid or biphasic during the acute phase of isoproterenol infusion. The incidence of these morphologic changes was higher in women than men (P < 0.05). (2) The QTc interval was initially prolonged and then shortened in both men and women during isoproterenol administration. However, QTc prolongation was significantly greater in women (0.44 ± 0.02 to 0.55 ± 0.03 sec) than men (0.42 ± 0.03 to 0.51 ± 0.04 sec; P < 0.05). (3) The QTc interval was significantly prolonged under autonomic blockade and the intrinsic QTc interval was longer in women than men (P < 0.05). Conclusion: While sympathetic stimulation and autonomic blockade modulated the dynamics of ventricular repolarization in both sexes, it was more pronounced in women. This gender difference may partially account for the susceptibility of women to arrhythmogenesis. Background: Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more common in women than men. Although increased sympathetic tone has an important role in vulnerability to arrhythmia, little is currently known regarding gender differences in the dynamic electrophysiological response to sympathetic stimulation. Therefore, we investigated whether there is a gender difference in humans with respect to the dynamic response of ventricular repolarization to β‐adrenergic stimulation and to autonomic blockade. Methods: Twelve‐lead ECGs were continuously recorded during isoproterenol infusion (protocol 1) and autonomic blockade with propranolol and atropine infusion (protocol 2) in 24 healthy volunteers (12 men, 23 ± 2 years; 12 women, 23 ± 5 years). QT (QTc) intervals were measured at the baseline and at a heart rate of 75, 100, and 120 beats/min. Results: (1) The morphology of the T wave dynamically and transiently changed to bifid or biphasic during the acute phase of isoproterenol infusion. The incidence of these morphologic changes was higher in women than men (P < 0.05). (2) The QTc interval was initially prolonged and then shortened in both men and women during isoproterenol administration. However, QTc prolongation was significantly greater in women (0.44 ± 0.02 to 0.55 ± 0.03 sec) than men (0.42 ± 0.03 to 0.51 ± 0.04 sec; P < 0.05). (3) The QTc interval was significantly prolonged under autonomic blockade and the intrinsic QTc interval was longer in women than men (P < 0.05). Conclusion: While sympathetic stimulation and autonomic blockade modulated the dynamics of ventricular repolarization in both sexes, it was more pronounced in women. This gender difference may partially account for the susceptibility of women to arrhythmogenesis. |
Author | TAKAHASHI, NAOHIKO HARA, MASAHIDE NAKAGAWA, MIKIKO ICHINOSE, MASASHI SAIKAWA, TETSUNORI YONEMOCHI, HIDETOSHI OOIE, TATSUHIKO OU, BAIQING |
Author_xml | – sequence: 1 givenname: MIKIKO surname: NAKAGAWA fullname: NAKAGAWA, MIKIKO organization: Department of Cardiovascular Science, Division of Laboratory Medicine – sequence: 2 givenname: TATSUHIKO surname: OOIE fullname: OOIE, TATSUHIKO organization: Department of Cardiovascular Science, Division of Laboratory Medicine – sequence: 3 givenname: BAIQING surname: OU fullname: OU, BAIQING organization: Department of Cardiovascular Science, Division of Laboratory Medicine – sequence: 4 givenname: MASASHI surname: ICHINOSE fullname: ICHINOSE, MASASHI organization: Department of Cardiovascular Science, Division of Laboratory Medicine – sequence: 5 givenname: NAOHIKO surname: TAKAHASHI fullname: TAKAHASHI, NAOHIKO organization: Department of Internal Medicine, Oita University, School of Medicine, Oita, Japan – sequence: 6 givenname: MASAHIDE surname: HARA fullname: HARA, MASAHIDE organization: Department of Internal Medicine, Oita University, School of Medicine, Oita, Japan – sequence: 7 givenname: HIDETOSHI surname: YONEMOCHI fullname: YONEMOCHI, HIDETOSHI organization: Department of Cardiovascular Science, Division of Laboratory Medicine – sequence: 8 givenname: TETSUNORI surname: SAIKAWA fullname: SAIKAWA, TETSUNORI organization: Department of Cardiovascular Science, Division of Laboratory Medicine |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/15817086$$D View this record in MEDLINE/PubMed |
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Snippet | Background: Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more... Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more common in... Background: Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more... |
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SubjectTerms | Adult Atropine - pharmacology autonomic blockade Autonomic Nervous System - drug effects Disease Susceptibility Electrophysiologic Techniques, Cardiac Female gender difference Humans isoproterenol Isoproterenol - administration & dosage Long QT Syndrome - chemically induced Long QT Syndrome - genetics Long QT Syndrome - physiopathology Male Propranolol - pharmacology QT interval Receptors, Adrenergic, beta - drug effects Risk Factors Sex Factors T wave Torsades de Pointes - chemically induced Torsades de Pointes - genetics Torsades de Pointes - physiopathology Ventricular Function - drug effects Ventricular Function - physiology |
Title | Gender Differences in Autonomic Modulation of Ventricular Repolarization in Humans |
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