Letter to the Editor: “Effects of Testosterone Replacement on Electrocardiographic Parameters in Men: Findings From Two Randomized Trials”

We thank Gagliano-Jucá et al. (1) for confirming our prior findings of QTc shortening in response to testosterone administration in men enrolled in randomized double-blind studies (2). We think it important to add that the QTc is also shortened in response to testosterone in women (2). Additionally, increased QT dispersion is another marker of increased risk for arrhythmias and sudden death in patients with heart failure, and we have shown this to be decreased in response to testosterone replacement in a randomized placebo-controlled trial (3). These changes may partly explain the reduction in mortality observed when hypogonadal men are treated with replacement testosterone to physiological levels (4).

The confirmatory findings of Gagliano-Jucá et al. are important to firmly establish the effects of testosterone on myocardial repolarization as measured by the QTc and facilitate incorporation into the knowledge base. However, in the spirit of scholarship, the inaccuracy of their statement that “However, the effect of testosterone replacement on QTc interval duration in men has not been studied in randomized controlled trials” should be acknowledged.

Acknowledgments

We acknowledge the contributions of our co-authors Maurizio Volterrani, MD; Giuseppe Caminiti, MD; Giuseppe Marazzi, MD; Massimo Fini, MD; Ferdinando Iellamo, MD; Chris J. Malkin, MBChB; Paul D. Morris, BMedSci; Peter J. Pugh, MBBS; and Kate M. English, PhD.

References