216-52: Adverse Effects of Elevated Testosterone and Low Estradiol Serum Levels on Disease Progression in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia. (10th June 2016) - Akdis, Deniz
Abstract: Purpose: Since male patients with ARVC/D present with more severe phenotype than females at similar ages, the aim of this study was to determine if serum sex hormone levels can predict adverse events in this cohort. Methods: Serum levels of testosterone, dehydroepiandrosterone, sex hormone binding globulin (SHBG), androstenedione, estradiol (E2), and progesterone, along with a routine panel of biochemical markers were measured in 48 patients from the Swiss ARVC/D registry. 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. The model was adjusted for known risk predictors such as male gender, prior MACE, and right ventricular and left ventricular function. Results: Twenty-seven patients (56%) experienced MACE during the study period. In male patients with MACE, testosterone levels and SHBG levels were significantly increased, whereas dehydroepiandrosterone levels were decreased. In females, E2 levels were lower in patients with MACE. In males, increased testosterone levels remained significantly associated with MACE after adjusting for established risk predictors. In males, a cut-off value for total serum testosterone of >13.9 nmol/l was associated with MACE with a sensitivity of 79% and a specificity of 75%. Conclusion: Our study shows for the first time that elevated testosterone and/or decreased E2 serum levels are independently associated with MACE, in patients with ARVC/D. Thus, determining the levels of these two sex hormones might be useful for risk stratification of patients with this disease.