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Drug-Induced Long QT Syndrome in Women

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Abstract

Congenital long QT syndromes (LQTS) are inherited heart diseases that can present as palpitations, syncope (fainting), seizures, cardiac arrest, and sudden death. Acquired LQTS mostly occurs as a result of exposure to an environmental stressor that is responsible for the excessive prolongation of the QT interval. The most common environmental stressor is adverse drug reactions, which can lead to drug-induced LQTS (di-LQTS). Female gender has been increasingly recognized as an independent risk factor for di-LQTS, which in females is influenced by other factors, including age, menstrual cycle, and hormone replacement therapy. The estrogen-mediated reduced repolarization reserve in women is believed to be responsible for their higher susceptibility to di-LQTS. More studies, especially randomized trials, should be carried out to confirm these findings, and elucidate the clinical impact of gender disparity in modifying the risk of di-LQTS in women, with the ultimate goal of promoting the clinical safety of medication. In this article, we review current knowledge about di-LQTS, specifically in women, and discuss methods for the prevention of di-LQTS in females.

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Acknowledgments

This work was supported by grants from the National Natural Science Foundation of China (81270236), Foundation of Chinese Medical Doctor Association (2013-1-21), Science and Technology R&D Program of Shaanxi (2010K15-05), and Xi’an Jiaotong University graduate independent innovation research (CX1116). The authors thank Dr. Rui Shi (Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine) for editing the manuscript and Dr. Changcong Cui (Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine) for helpful advice.

Conflict of interest

Guoliang Li, Gong Cheng, Jine Wu, Xin Zhou, Ping Liu, and Chaofeng Sun declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University College of Medicine, No. 277 Yanta West Road, Xi’an, 710061, Shaanxi, People’s Republic of China

    Guoliang Li, Jine Wu, Xin Zhou & Chaofeng Sun

  2. Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, Shaanxi, People’s Republic of China

    Gong Cheng

  3. Department of Endocrinology, Xi’an Central Hospital, Xi’an, Shaanxi, People’s Republic of China

    Ping Liu

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  1. Guoliang Li
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  2. Gong Cheng
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  3. Jine Wu
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  4. Xin Zhou
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  5. Ping Liu
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  6. Chaofeng Sun
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Corresponding author

Correspondence to Chaofeng Sun.

Additional information

G. Li and G. Cheng contributed equally to this work.

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Li, G., Cheng, G., Wu, J. et al. Drug-Induced Long QT Syndrome in Women. Adv Ther 30, 793–802 (2013). https://doi.org/10.1007/s12325-013-0056-x

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