Abstract 11027: Elevated Serum Testosterone Levels are Associated With Adverse Events in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia
Introduction: Sex hormones have been reported to play a role in the pathophysiology of ventricular arrhythmias.
Hypothesis: We hypothesized that there may be a relationship between sex hormones and cardiovascular adverse events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D).
Methods: Serum levels of testosterone, dehydroepiandrosterone, sex steroid-binding globulin, androstendione, estradiol, and progesterone were measured along with routine biochemical markers in 44 patients (33 male) from the Swiss ARVC/D Registry with a definite (n=29) or borderline (n=15) diagnosis of ARVC/D. Sex hormone levels were correlated with major adverse cardiovascular events (MACE), defined as the occurrence of cardiac death, heart transplantation, survived sudden cardiac death, ventricular fibrillation, sustained ventricular tachycardia or arrhythmogenic syncope.
Results: Twenty-four patients experienced MACE within the last six months prior to determination of sex hormone levels. Testosterone levels were significantly higher in patients with MACE (mean±SD: 14nmol/l±9.6 versus 8.6nmol/l±5.9;p=0.03). In male patients with MACE, testosterone levels (18.7nmol/l±5.8 versus 11.3nmol/l±3.8; p=0.001) and sex steroid-binding globulin levels (48.9nmol/l±20.8 versus 32nmol/l±12.2; p=0.01) were significantly increased, whereas dehydroepiandrosterone levels were significantly decreased (4.0 micromol/l±2.6 versus 7.0 micromol/l±4.4; p=0.03). In females estradiol was lower in patients with MACE (14.1pmol/l±3.8 versus 396.6pmol/l±336.2; p=0.007). In bivariable analysis after adjusting for confounders such as body mass index, sports activity, and reduced RV/LV function, increased testosterone levels remained a significant independent predictor of MACE in males (odds ratio 1.4 per 1 nmol/l increase, 95% confidence interval 1.1-1.8, p=0.005). A cut-off value for testosterone at 13.45 nmol/l predicted MACE with a sensitivity of 0.8 and a specificity of 0.7.
Conclusion: In conclusion, our study suggests that sex hormones, in particular testosterone, are associated with adverse clinical events in patients with ARVC/D, and therefore, may play a role in risk stratification of this disease.
Author Disclosures: D. Akdis: None. A. Saguner: None. A. von Eckardstein: None. H. Chen: None. C. Brunckhorst: None. F. Duru: None.
- © 2015 by American Heart Association, Inc.