ADT Can Alter The Heart’s Electrophysiological Response

In the last decade there have been over 50 papers in the medical literature concerning the cardiovascular risks associated with various forms of ADT. Most, though, have focused on the risk of a lethal myocardial infarction (i.e., a heart attack). This is where a blood vessel serving the heart itself is blocked and the heart muscle dies.

This paper is a bit different in that it focuses on the heart’s conduction system, which is assessed with an electrocardiogram (ECG). The researchers found prolongation of part of the ECG wave form called the QTc segment. This is of concern because prolonged QTc might predispose patients to cardiac arrhythmias (i.e., irregular heart beats). 

Two things to note…. 

This was a short-term (only 6-month) prospective study with just 33 men on ADT. None of these men had more cardiovascular events than those in the control group of 38 men. None died. Thus ADT may alter the electrophysiology of the heart, and that may help us understand how ADT affects heart physiology. However, the amount of prolongation of the QTc wave observed in this study is not necessarily indicative of lethal arrhythmias, at least not in the short term.

To read the full article, please see:

Gagliano-Jucá T, Travison TG, Kantoff PW, Nguyen PL, Taplin ME, Kibel AS, Huang G, Bearup R, Schram H, Manley R, Beleva YM, Edwards RR, Basaria S. Androgen Deprivation Therapy Is Associated With Prolongation of QTc Interval in Men With Prostate Cancer. J Endocr Soc. 2018 Apr 20;2(5):485-496. doi: 10.1210/js.2018-00039.