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Effect of Antiepilepsy Drug Therapy on Ventricular Function in Children With Epilepsy: A Tissue Doppler Imaging Study

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Abstract

Impaired cardiac myocardial function may contribute to the risk for sudden unexpected death of a patient with epilepsy. This study aimed to investigate the effect of antiepilepsy drugs (AEDs) on cardiac function in pediatric epileptic patients using standard and tissue Doppler imaging (TDI) echocardiography. This hospital-based, prospective cross-sectional study investigated 52 epileptic children (mean age 9.3 ± 3.1 years) treated with AEDs (duration 2.4–10.0 years) and 36 healthy children (mean age 9.5 ± 4.0 years). In the epilepsy group, standard echocardiography showed increased left ventricular (LV) end-diastolic and end-systolic diameters, an increased LV mass index, and preserved ejection fraction. The patients also exhibited increased mitral peak A-wave velocity and mitral E-wave deceleration time as well as a decreased mitral E/A ratio. The E/Em ratio was significantly higher in the epilepsy group (5.6 ± 1.2) than in the control group (5.2 ± 1.1) (p = 0.016). In the epilepsy group, TDI showed an increased isovolumetric relaxation time and myocardial performance index (MPI). It also exhibited decreased early diastolic velocity (Em) and a decreased mitral annular displacement index in these patients. There were positive correlations between the LV lateral wall MPI (r = 0.231), septal MPI (r = 0.223), and LV mass index (p < 0.05) but no correlation with the duration of AED treatment. The authors detected subclinical ventricular dysfunction associated with AEDs at a preclinical stage. They suggest that TDI can be useful for determining the short- and long-term cardiac effects of AEDs.

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Abbreviations

VPA:

Valproic acid

CBZ:

Carbamazepine

TPM:

Topiramate

LTG:

Lamotrigine

LEV:

Levetiracetam

TDI:

Tissue Doppler imaging

AED’s:

Antiepileptic drugs

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Conflict of interest

The authors report no conflicts of interest in this work.

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Mersin Women’s and Children’s Hospital, Güneykent, Mersin, Turkey

    Ayse Esin Kibar & Sevcan Erdem

  2. Department of Pediatric Neurology, Mersin Women’s and Children’s Hospital, Mersin, Turkey

    Olcay Unver

  3. Department of Pediatric Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

    Mehmet Burhan Oflaz

  4. Department of Neurology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

    Ahmet Sami Güven & Fusun Dilara İçağasıoğlu

  5. Department of Pediatric Cardiology, Balikkesir Hospital, Balıkesir, Turkey

    Sevket Balli

  6. Department of Pediatric Cardiology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey

    İbrahim Ece

Authors
  1. Ayse Esin Kibar
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  2. Olcay Unver
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  3. Mehmet Burhan Oflaz
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  4. Ahmet Sami Güven
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  5. Sevket Balli
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  7. Sevcan Erdem
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  8. Fusun Dilara İçağasıoğlu
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Correspondence to Ayse Esin Kibar.

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Kibar, A.E., Unver, O., Oflaz, M.B. et al. Effect of Antiepilepsy Drug Therapy on Ventricular Function in Children With Epilepsy: A Tissue Doppler Imaging Study. Pediatr Cardiol 35, 280–288 (2014). https://doi.org/10.1007/s00246-013-0771-8

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  • DOI: https://doi.org/10.1007/s00246-013-0771-8

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