P G Hiremath1, F Bhondoekhan2, S A Haberlen2, H Ashikaga1, F J Palella3, G D'Souza2, M J Budoff4, L A Kingsley5, A S Dobs6, W S Post1,2, E Z Soliman7, T T Brown6, K C Wu1. 1. Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 3. Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 4. Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA. 5. Departments of Infectious Diseases and Microbiology and Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA. 6. Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 7. Division of Public Health Sciences, Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center (EPICARE), Winston-Salem, NC, USA.
Abstract
OBJECTIVES: Testosterone usage (T-use) may alter risk factors for sudden cardiac death in men living with HIV (MLWH). Electrocardiographic QT interval prolongation, which could potentiate ventricular arrhythmias, has previously been associated with HIV infection and, separately, with low testosterone levels. We investigated whether T-use shortens the QT interval duration in MLWH and HIV-uninfected men. METHODS: We utilized data from the Multicenter AIDS Cohort Study, a prospective, longitudinal study of HIV infection among men who have sex with men. Multivariable linear regression analyses were used to evaluate associations between T-use and corrected QT interval (QTc) duration. RESULTS: Testosterone usage was more common in MLWH compared with HIV-uninfected men (19% vs. 9%). In a multivariable regression analysis, T-use was associated with a 5.7 ms shorter QT interval [95% confidence interval (CI): -9.5 to -1.9; P = 0.003). Furthermore, stronger associations were observed for prolonged duration of T-use and recent timing of T-use. CONCLUSIONS: This study is the first known analysis of T-use and QTc interval in MLWH. Overall, our data demonstrate that recent T-use is associated with a shorter QTc interval. Increased T-use duration above a threshold of ≥ 50% of visits in the preceding 5 years was associated with a shorter QTc interval while lesser T-use duration was not.
OBJECTIVES: Testosterone usage (T-use) may alter risk factors for sudden cardiac death in men living with HIV (MLWH). Electrocardiographic QT interval prolongation, which could potentiate ventricular arrhythmias, has previously been associated with HIV infection and, separately, with low testosterone levels. We investigated whether T-use shortens the QT interval duration in MLWH and HIV-uninfected men. METHODS: We utilized data from the Multicenter AIDS Cohort Study, a prospective, longitudinal study of HIV infection among men who have sex with men. Multivariable linear regression analyses were used to evaluate associations between T-use and corrected QT interval (QTc) duration. RESULTS: Testosterone usage was more common in MLWH compared with HIV-uninfected men (19% vs. 9%). In a multivariable regression analysis, T-use was associated with a 5.7 ms shorter QT interval [95% confidence interval (CI): -9.5 to -1.9; P = 0.003). Furthermore, stronger associations were observed for prolonged duration of T-use and recent timing of T-use. CONCLUSIONS: This study is the first known analysis of T-use and QTc interval in MLWH. Overall, our data demonstrate that recent T-use is associated with a shorter QTc interval. Increased T-use duration above a threshold of ≥ 50% of visits in the preceding 5 years was associated with a shorter QTc interval while lesser T-use duration was not.
Authors: Zian H Tseng; Eric A Secemsky; David Dowdy; Eric Vittinghoff; Brian Moyers; Joseph K Wong; Diane V Havlir; Priscilla Y Hsue Journal: J Am Coll Cardiol Date: 2012-05-22 Impact factor: 24.094
Authors: S A Haberlen; L P Jacobson; F J Palella; A Dobs; M Plankey; J E Lake; L A Kingsley; R Stall; W S Post; T T Brown Journal: HIV Med Date: 2018-07-10 Impact factor: 3.180
Authors: Elena Tomaselli Muensterman; Heather A Jaynes; Kevin M Sowinski; Brian R Overholser; Changyu Shen; Richard J Kovacs; James E Tisdale Journal: Circulation Date: 2019-09-23 Impact factor: 29.690
Authors: Katherine C Wu; Long Zhang; Sabina A Haberlen; Hiroshi Ashikaga; Todd T Brown; Matthew J Budoff; Gypsyamber D'Souza; Lawrence A Kingsley; Frank J Palella; Joseph B Margolick; Otoniel Martínez-Maza; Elsayed Z Soliman; Wendy S Post Journal: Heart Date: 2018-10-26 Impact factor: 5.994
Authors: Katherine C Wu; Fiona Bhondoekhan; Sabina A Haberlen; Hiroshi Ashikaga; Todd T Brown; Matthew J Budoff; Gypsyamber D'Souza; Jared W Magnani; Lawrence A Kingsley; Frank J Palella; Joseph B Margolick; Otoniel Martínez-Maza; Sean F Altekruse; Elsayed Z Soliman; Wendy S Post Journal: Ann Noninvasive Electrocardiol Date: 2019-09-19 Impact factor: 1.468