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Articles in PresS, published online ahead of print January 10, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00962.2001
Submitted on November 2, 2001
Accepted on January 4, 2002
1 Cardiological Sciences, St. George's Hospital Medical School, London, United Kingdom
* To whom correspondence should be addressed. E-mail: m.malik{at}sghms.ac.uk.
The reason for sex differences in arrhythmic risk is still unclear. Since heterogeneity of ventricular repolarisation is directly linked to arrhythmogenesis, we investigated repolarisation homogeneity and its circadian pattern in men and women. During 24-hour holter recordings in 60 healthy subjects (27 males), a 12-lead ECG was obtained every 30 seconds. RR intervals, QT intervals, and, after single value decomposition, two characteristics of repolarisation homogeneity were calculated in each ECG. QTc values were obtained using an individually optimised heart rate correction formula. All values were averaged over 10-minute time-bands from 00:00 to 24:00 hours. There were substantial sex differences in both global repolarisation homogeneity, measured by the total cosine of the angle between between QRS and T wave vectors (TCRT), and regional homogeneity of repolarisation, quantified independently by the relative T wave residuum (TWR). Whereas women throughout the 24 hours followed more closely the pattern of inverse sequence between depolarisation and repolarisation they also showed much higher localised repolarisation heterogeneity than men. Both in women and in men, repolarisation irregularity was greatest during morning hours. A sex difference was also observed for the heart rate and heart rate corrected QT interval. However, the circadian patterns of the repolarisation homogeneity descriptors were different from those of heart rate and corrected QT intervals.
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