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Published on: June 20, 2020
Sex hormones and arrhythmia risk in women with long QT syndrome
Andrea Greco1, Valeria Donno2, Estefanía Martínez-Barrios3
1Pediatric Arrhythmias, Genetic Cardiology and Sudden Death, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Arrhythmia, Inherited Cardiac Diseases and Sudden Death Unit, Department of Cardiology, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain; European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, Amsterdam, The Netherlands; Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.
Abstract:
Sex-related differences in the QT interval become evident from puberty to menopause. Sex steroid hormones have been suggested to play a role in cardiac repolarization, though their impact remains a matter of debate. These effects are especially pronounced in women with inherited long QT syndrome (LQTS) and may face a higher risk of QT variability associated with endogenous or exogenous hormonal fluctuations. This narrative review aimed to summarize the impact of physiological hormonal fluctuations on QT interval in women with LQTS across the female lifespan, including menstrual cycle, pregnancy and postpartum, and menopause, concluding with exogenous hormonal administration such as oral contraceptives and ovarian stimulation in assisted reproductive technologies, highlighting potential genotype-specific differences. Insights gained from this review may inform more precise risk stratification, optimize individualized management, and improve safety for women with LQTS across their reproductive lifespan.
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