Arrhythmias & electrophysiology
Sex Hormone Profiles in Patients With Torsades de Pointes Ventricular Tachycardia: A Clinical-Electrophysiological Translational Study
Authors' conclusion
Different sex hormone profiles, primarily low testosterone in male patients and high 17β-estradiol in female patients, are associated with TdP occurrence and outcome in men and women. These endocrine milieus act, at least in part, via direct and reversible effects on cardiac electrophysiology, thereby supporting the antiarrhythmic potential of sex-specific hormonal-modulating therapies.
Study context
- Population
- Male and female patients who developed torsades de pointes (TdP)42 female
- Participants
- 68 participants
- Exposure
- TdP patients vs control subjects
- TdPn = 68
- Outcome
- Sex hormone levels in male and female TdP patients
Methodological detailswith in vitro mechanistic study, Consecutive enrolment over 13 years
- With in vitro mechanistic study
- Consecutive enrolment over 13 years
Main finding
As reported in the abstract
Sex hormone profile vs control subjects
- Reduced testosterone in male TdP patients vs control subjects
- Increased 17β-estradiol in female TdP patients vs control subjects
Observational data: associations, not effects.
Further findings
Short-term arrhythmia outcome within the TdP cohort
- Lower testosterone in men and higher 17β-estradiol in women associated with worse short-term arrhythmia outcome
Action potential duration in vitro (guinea pig ventricular myocytes, hiPSC-derived cardiomyocytes)
- Sex-specific TdP hormone profiles prolonged action potential duration in sex-matched cardiomyocytes; reversed by testosterone (male) and progesterone (female)
Original publication
Sex Hormone Profiles in Patients With Torsades de Pointes Ventricular Tachycardia: A Clinical-Electrophysiological Translational Study. JACC Clin Electrophysiol. Published 28 August 2025. doi:10.
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