{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T19:28:13Z","timestamp":1778700493478,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T00:00:00Z","timestamp":1635033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The effects of gender differences on cardiac parameters have been well-established. In this study, we aimed to evaluate the possible associations of plasma levels of different sex hormones with premature atrial or ventricular contractions in premenopausal women. Materials and Methods: We conducted a prospective study which included women in late reproductive age who presented with palpitations during an eight-month period. A 12-lead electrocardiography, a transthoracic echocardiogram, blood samples, and 24-hour rhythm Holter were conducted on the third day of the menstrual cycle. Results Overall, 93 healthy premenopausal women with a median age of 42 years were enrolled. QTc interval was within normal limits in all patients. The 24 h range of premature atrial contractions (PACs) and premature ventricular contractions (PVCs) was 0\u20136450 and was 0\u201321,230, respectively. The median number of PVCs was 540 and the median number of PACs was 212, respectively. In total, 51 patients (54.8%) had a frequency of PVCs &gt; 500\/24 h and 37 patients (39.8%) had a frequency of PACs &gt; 500\/24 h, respectively. No statistically significant association was shown between any hormone and the frequency of PACs. Regarding PVCs, patients with a PVCs frequency &gt; 500\/24 h had higher estradiol levels compared to patients with PVCs less than 500\/24 h (median 60 pg\/mL versus 42 pg\/mL, p = 0.02, OR: 1.01). No association was found between PVCs and other hormones. Conclusions: In premenopausal healthy women, higher estradiol levels are independently associated with increased PVCs. This suggests that estradiol in late reproductive stages may exert proarrhythmic effects.<\/jats:p>","DOI":"10.3390\/medicina57111154","type":"journal-article","created":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T22:07:11Z","timestamp":1635113231000},"page":"1154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Effects of Different Hormones on Supraventricular and Ventricular Premature Contractions in Healthy Premenopausal Women"],"prefix":"10.3390","volume":"57","author":[{"given":"Elias","family":"Tsougos","sequence":"first","affiliation":[{"name":"Heart Failure and Preventive Cardiology Section, Department of Cardiology, Hygeia Hospital, 15123 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-5488","authenticated-orcid":false,"given":"Emmanouil","family":"Korakas","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Kolovos","sequence":"additional","affiliation":[{"name":"Heart Failure and Preventive Cardiology Section, Department of Cardiology, Hygeia Hospital, 15123 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia-Angeliki","family":"Koliou","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Independent Researcher, 10674 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5829-7327","authenticated-orcid":false,"given":"Aikaterini","family":"Kountouri","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Balampanis","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loukia","family":"Pliouta","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Savvas","family":"Loizos","sequence":"additional","affiliation":[{"name":"Heart Failure and Preventive Cardiology Section, Department of Cardiology, Hygeia Hospital, 15123 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Karamichalakis","sequence":"additional","affiliation":[{"name":"Heart Failure and Preventive Cardiology Section, Department of Cardiology, Hygeia Hospital, 15123 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Gatos","sequence":"additional","affiliation":[{"name":"Embio Medical Center, 15231 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8241-7886","authenticated-orcid":false,"given":"Ignatios","family":"Ikonomidis","sequence":"additional","affiliation":[{"name":"Second Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paraskevi","family":"Kazakou","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, National and Kapodistrian University of Athens,11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasios","family":"Raptis","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaia","family":"Lambadiari","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1111\/j.1540-8167.1998.tb00950.x","article-title":"Effects of gender on cardiac arrhythmias","volume":"9","author":"Larsen","year":"1998","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_2","first-page":"690","article-title":"Sex differences in the evolution of the electrocardiographic QT interval with age","volume":"8","author":"Rautaharju","year":"1992","journal-title":"Can. J. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2590","DOI":"10.1001\/jama.1993.03510210076031","article-title":"Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs","volume":"270","author":"Makkar","year":"1993","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.pharmthera.2007.04.008","article-title":"Regulation of cardiac ion channels via non-genomic action of sex steroid hormones: Implication for the gender difference in cardiac arrhythmias","volume":"115","author":"Furukawa","year":"2007","journal-title":"Pharmacol. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.pharmthera.2016.07.005","article-title":"Influence of steroid hormones on ventricular repolarization","volume":"167","author":"Salem","year":"2016","journal-title":"Pharmacol. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1161\/CIRCULATIONAHA.106.678326","article-title":"Thyroid disease and the heart","volume":"116","author":"Klein","year":"2007","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.3389\/fphys.2018.01669","article-title":"Diabetes and Arrhythmias: Pathophysiology, Mechanisms and Therapeutic Outcomes","volume":"9","author":"Grisanti","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1002\/ejhf.1493","article-title":"Pathophysiology, diagnosis and management of peripartum cardiomyopathy: A position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy","volume":"21","author":"Bauersachs","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_9","first-page":"euz046","article-title":"Management of asymptomatic arrhythmias: A European Heart Rhythm Association (EHRA) consensus document, endorsed by the Heart Failure Association (HFA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Cardiac Arrhythmia Society of Southern Africa (CASSA), and Latin America Heart Rhythm Society (LAHRS)","volume":"18","author":"Arnar","year":"2019","journal-title":"Europace"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1038\/sj.bjp.0706850","article-title":"Greater antiarrhythmic activity of acute 17beta-estradiol in female than male anaesthetized rats: Correlation with Ca2+ channel blockade","volume":"149","author":"Philp","year":"2006","journal-title":"Br. J. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.bbrc.2007.07.054","article-title":"Oestrogen directly inhibits the cardiovascular L-type Ca2+ channel Cav1.2","volume":"361","author":"Ullrich","year":"2007","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1113\/jphysiol.2010.203398","article-title":"Regional genomic regulation of cardiac sodium-calcium exchanger by oestrogen","volume":"589","author":"Chen","year":"2011","journal-title":"J. Physiol."},{"key":"ref_13","first-page":"55","article-title":"Amelioration of ischemia- and reperfusion-induced myocardial injury by the selective estrogen receptor modulator, raloxifene, in the canine heart","volume":"39","author":"Ogita","year":"2002","journal-title":"J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1111\/pace.12821","article-title":"The Effects of Female Sex Hormones on Ventricular Premature Beats and Repolarization Parameters in Physiological Menstrual Cycle","volume":"39","author":"Dogan","year":"2016","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.acvd.2010.11.011","article-title":"Effect of oestrogen replacement therapy on idiopathic outflow tract ventricular arrhythmias in postmenopausal women","volume":"104","author":"Hu","year":"2011","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2776","DOI":"10.1210\/jc.2016-1877","article-title":"Complex Influence of Gonadotropins and Sex Steroid Hormones on QT Interval Duration","volume":"101","author":"Abehsira","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2611","DOI":"10.1152\/jappl.2001.91.6.2611","article-title":"Gender differences in autonomic cardiovascular regulation: Spectral, hormonal, and hemodynamic indexes","volume":"91","author":"Evans","year":"2001","journal-title":"J. Appl. Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/j.1440-1681.1985.tb00899.x","article-title":"Plasma noradrenaline and its relationship to plasma oestradiol in normal women during the menstrual cycle","volume":"12","author":"Davidson","year":"1985","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1161\/CIRCRESAHA.114.303772","article-title":"Role of the autonomic nervous system in atrial fibrillation: Pathophysiology and therapy","volume":"114","author":"Chen","year":"2014","journal-title":"Circ. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1089\/jwh.2015.5556","article-title":"Perimenopause: From Research to Practice","volume":"25","author":"Santoro","year":"2016","journal-title":"J. Womens Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1089\/jwh.2011.3444","article-title":"Sex hormones and the QT interval: A review","volume":"21","author":"Sedlak","year":"2012","journal-title":"J. Womens Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0378-5122(00)00123-7","article-title":"Resting ECG is modified after oophorectomy and regresses with estrogen replacement therapy in premenopausal women","volume":"36","author":"Agricola","year":"2000","journal-title":"Maturitas"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/S0002-9149(00)01377-1","article-title":"Effect of low estrogen states in healthy women on dispersion of ventricular repolarization","volume":"87","author":"Saba","year":"2001","journal-title":"Am. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0167-5273(00)00317-X","article-title":"Effects of progestin-estrogen replacement therapy on QT-dispersion in postmenopausal women","volume":"75","author":"Haseroth","year":"2000","journal-title":"Int. J. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/j.1542-474X.2004.94580.x","article-title":"Estrogen and progestin use and the QT interval in postmenopausal women","volume":"9","author":"Kadish","year":"2004","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/S0002-9149(96)00707-2","article-title":"Gender-specific differences in the QT interval and the effect of autonomic tone and menstrual cycle in healthy adults","volume":"79","author":"Burke","year":"1997","journal-title":"Am. J. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.1542-474X.2004.92530.x","article-title":"Menstrual cycle and ST height","volume":"9","author":"Endres","year":"2004","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/j.1540-8159.2006.00407.x","article-title":"Influence of menstrual cycle on QT interval dynamics","volume":"29","author":"Nakagawa","year":"2006","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/CRD.0b013e318259294b","article-title":"Effect of female sex on cardiac arrhythmias","volume":"20","author":"Gowd","year":"2012","journal-title":"Cardiol Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/0735-1097(89)90479-8","article-title":"Effect of thyroid replacement therapy on the frequency of benign atrial and ventricular arrhythmias","volume":"14","author":"Polikar","year":"1989","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","first-page":"318","article-title":"Cardiac and metabolic effects in patients who present with a multinodular goitre","volume":"61","author":"Berghout","year":"2003","journal-title":"Neth. J. Med."},{"key":"ref_32","first-page":"121","article-title":"Influence of inflammation and adipocyte biochemical markers on the components of metabolic syndrome","volume":"20","author":"Vesa","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Babes, E.E., Zaha, D.C., Tit, D.M., Nechifor, A.C., Bungau, S., Andronie-Cioara, F.L., Behl, T., Stoicescu, M., Munteanu, M.A., and Rus, M. (2021). Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes. Diagnostics, 11.","DOI":"10.3390\/diagnostics11050850"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"690","DOI":"10.3892\/etm.2021.10122","article-title":"Diabetic neuropathy: A narrative review of risk factors, classification, screening and current pathogenic treatment options (Review)","volume":"22","author":"Bondar","year":"2021","journal-title":"Exp. Ther. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/11\/1154\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:22:17Z","timestamp":1760167337000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/11\/1154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,24]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["medicina57111154"],"URL":"https:\/\/doi.org\/10.3390\/medicina57111154","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,24]]}}}