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Gender-Specific Differences in the QT Interval and the Effect of Autonomic Tone and Menstrual Cycle in Healthy Adults
Abstract
Gender differences in the corrected QT interval have been noted since Bazett's initial description during the 1920s. The mechanism of this gender difference is unknown, and this study was undertaken to evaluate potential autonomic and menstrual cycle effects on the QT interval. The study population consisted of a healthy volunteer sample of 23 women and 20 men. Twelve-lead electrocardiographic determinations were made at rest and following double autonomic blockade (with atropine and propranolol) during the menstrual, follicular, and luteal phases of the menstrual cycle. Men were studied during 3 separate visits as controls. The corrected QT interval at baseline tended to be longer in women than men (421 +/- 16 ms vs 414 +/- 15 ms: p <0.07). Following double autonomic blockade, the corrected QT interval increased to 439 +/- 11 ms: p <0.001). However, the gender difference in corrected QT interval was unchanged (443 +/- 15 ms vs 437 +/- 12 ms). At baseline, there was no significant difference in the corrected QT interval among the 3 phases of the menstrual cycle (421 +/- 10, 423 +/- 18, and 420 +/- 18 in the menstrual, follicular, and luteal phases, respectively) and the corrected QT interval was longer in women than men at each visit. Following double autonomic blockade, the corrected QT interval in women was shorter in the luteal phase (438 +/- 16 ms) versus the menstrual (446 +/- 15 ms) or the follicular phase (444 +/- 13 ms; p <0.05). However, this difference, which was not present at baseline, does not appear to be responsible for the gender difference in the QT interval at rest. In conclusion, our results confirm that the corrected QT interval tends to be longer in women than men. Differences in autonomic tone and menstrual cycle variability in the corrected QT in women at rest do not appear to be responsible for the gender differences in the QT interval. The mechanism responsible for the longer QT interval in women remains to be defined.
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“previous experiments suggest that different stages of the menstrual cycle had no effect on cardiac QT interval or autonomic tone (Burke et al. 1997)”
From Oral nitrate and citrulline decrease blood pressure and increase vascular conductance in young adults: a potential therapy for heart failure (2016) · cites this paper as Burke et al. 1997
In the citing paper
“indicate that gender differences in cardiac electrical activity are not a consequence of oestrogen (Burke et al. 1997).”
From Oral nitrate and citrulline decrease blood pressure and increase vascular conductance in young adults: a potential therapy for heart failure (2016) · cites this paper as Burke et al. 1997
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Metadata
- Authors
- Burke, J. H., Ehlert, F. A., Kruse, J. T., Parker, M. A., Goldberger, J. J., & Kadish, A. H.
- Affiliations
- Northwestern University (US)
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1997-01
- Volume
- 79
- Issue
- 2
- Pages
- 178-181
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2127467308
- Cited by
- 189
- References
- 27
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 8 · 2021: 7 · 2020: 13 · 2019: 7 · 2018: 10 · 2017: 8 · 2016: 8 · 2015: 7 · 2014: 7 · 2013: 8 · 2012: 10
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01 RR00048, M01RR000048)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Keywords
- QT interval, sex differences, menstrual cycle, autonomic tone, atropine, propranolol, luteal phase, follicular phase
- MeSH terms
- Adult, Atropine, Autonomic Nervous System, Electrocardiography, Female, Follicular Phase, Heart Conduction System, Heart Rate, Humans, Luteal Phase, Male, Menstrual Cycle, Menstruation, Parasympatholytics, Propranolol, Rest, Sex Characteristics, Sympatholytics, Multivariate Analysis
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