Erzat TOPRAK, Özgür ÇİFTÇİ, Faika Ceylan ÇİFTÇİ, Erdem TURHAN, Ayla ÜÇKUYU, Emel Ebru ÖZÇİMEN

Effect of ovulation induction on QT dispersion in electrocardiography

To investigate whether ovulation induction resulting in supra-physiological concentration range of ovarian hormones has an effect on interlead ventricular depolarization heterogeneity via QT dispersion measurements. Estrogens influence the duration of cardiac repolarization but there is no significant change in the QT interval duration within the range of physiological estradiol variations. Materials and methods: Included in the study were 40 subjects, in whom ovulation induction was planned, and 20 volunteers. During the study, a 12-lead electrocardiogram of each woman was carried out 3 times: for the first time on day 2-3 of the menstrual cycle (menstrual day), for the second time 36 h after hCG administration (ovulatory day), and for the third time at 6-8 days following ovulation (mid-luteal day). The RR and QT wave distances were measured. The QT interval corrected for heart rate (corrected QT) was calculated for each derivation. The difference between the longest and shortest corrected QT intervals was determined as corrected QT dispersion. Results: No difference was seen in the mean QT and corrected QT interval duration and the maximum corrected QT interval duration between menstrual phases. On the ovulatory day at peak estrogen level, the corrected QT dispersion was found to be lower than on mid-luteal and menstrual day. Conclusion: QT dispersion demonstrates the regional repolarization heterogeneity of the myocardium, which reflects the propensity of ventricular arrhythmia decreases on the ovulatory day of the ovulation induction cycle.

Anahtar Kelimeler:

Key words: Estrogen, ventricular repolarization, ventricular arrhythmia, ovulation induction

Effect of ovulation induction on QT dispersion in electrocardiography

Keywords:

Key words: Estrogen, ventricular repolarization, ventricular arrhythmia, ovulation induction,

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Stumpf W. Steroid hormones and the cardiovascular system: direct actions of estradiol, progesterone, testosterone, gluco- and mineralocorticoids, and soltriol (vitamin D) on central nervous regulatory and peripheral tissues. Experientia 1990; 46: 13-25.
Merri M, Benhozin J, Alberti M, Locati E, Moss AJ. Electrocardiographic quantitation of ventricular repolarization. Circulation 1989; 80: 1301-8.
Drici MD, Burklow TR, Haridasse V, Glazer RI, Woosley RL. Sex hormones prolong the QT interval and downregulate potassium channel expression in the rabbit heart. Circulation 1996; 94: 1471-4.
Hantukova K, Malik M, Yi G, Camm AJ. Adjustment of QT dispersion assessed from 12 lead ECG’s for diff erent number of analysed electrocardiographic leads: comparison of stability of diff erent methods. Br Heart J 1994; 72: 390-6. 5. Loo AV, Arendts W, Hohnloser SH. Variability of QT dispersion measurements in the surface electrocardiogram in patients with acute myocardial infarction and in normal subjects. Am J Cardiol 1994; 74: 1113-8.
Pye MP, Cobbe SM. Mechanisms of ventricular arrhythmias in cardiac failure and hypertrophy. Cardiovasc Res 1992; 26: 740- 50.
Elming H, Holm E, Jun L, Top-Pedersen C, Kober L, Kircshoff M et al. Th e prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998; 19: 1391- 400.
Bazett HC. An analysis of time relations of electrograms. Heart 1920; 7: 353-70.
Hodges M, Salerno Q, Erlien D. Bazett’s QT correction reviewed. Evidence that a linear QT correction for heart rate is better. J Am Coll Cardiol 1983; 1: 694.
Hulot JS, Demolis JL, Riviere R, Strabach S, Christin-Maitre S, Funck-Brentano C. Infl uence of endogenous oestrogens on QT interval duration. Eur Heart J 2003; 24: 1663-7.
Nakagawa M, Ooie T, Takahashi N, Taniguchi Y, Anan F, Yonemochi H et al. Infl uence of menstrual cycle on QT interval dynamics. Pacing Clin Electrophysiol 2006; 29: 607-13.
Saba S, Link M, Homoud MK, Wang P, Estes III NAM. Eff ect of low estrogen states in healthy women on dispersion of ventricular repolarization. Am J Cardiol 2001; 87: 354-6.
Coumel PL, Maison-Blance P, Badilini F. Dispersion of ventricular repolarization: Realty? Illusion? Signifi cance. Circulation 1998; 97: 2491-3.
Zdarska D, Peliskova P, Charvat J, Slavicek J, Mlcek M, Medova E, et al. ECG body surface mapping (BSM) in type 1 diabetic patient. Physiol Res 2007; 56: 403-10.
Nahshoni E, Weizman A, Yaroslavsky A, Toledano A, Sulkes J, Stein D. Alterations in QT dispersion in the surface electrocardiogram of female adolescents diagnosed with restricting-type anorexia nervosa. J Psychosom Res 2007; 62: 469-72.
Yelken B, Tanriverdi B, Cetinbas F, Memis D, Süt N. Th e assessment of QT intervals in acute carbon monoxide poisoning - Original Investigation. Anadolu Kardiyol Derd 2009; 9: 397-400.
Yildirir A, Aksoyek S, Calguneri M, Aytemir K, Kabakci G, Ovunc K. QT dispersion as a predictor of arrhythmic events in patients with ankylosing spondylitis. Rheumatology (Oxford) 2000; 39: 875-9.
Shugushev KhKh, Shugushev ZKh, Khamizova MM, Vasilenko VM. Eff ect of programmed hemodialysis on parameters of ventricular repolarization and cardiac rhythm disturbances in patients with terminal renal failure. Kardiologiia 2004; 44: 67- 70.
Monfared A, Ghods AJ. Improvement of maximum corrected QT and corrected QT dispersion in electrocardiography aft er kidney transplantation. Iran J Kidney Dis 2008; 2: 95-8.
Osada M, Tanaka Y, Komai T, Maeda Y, Kohno Ii, Umetani K et al. QT dispersion in patients with severe burns in intensive care unit. Intensive Care Med 2000; 26: 1581.
Mayet J, Kanagaratnam P, Shahi M, Senior R, Doherty M, Poulter NR et al. QT dispersion in athletic left ventricular hypertrophy. Am Heart J 1999; 137: 678-81.