Related Experiment Video
Updated: Oct 29, 2025
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Left ventricular dysfunction and cardiac autonomic imbalance in children with drug-resistant epilepsy
Ahmed Ibrahim1, Walaa M Soliman1, Badr El-Din M Mesbah1
1Department of Pediatrics, Faculty of Medicine, Suez Canal University, Egypt.
Insights
Children with drug-resistant epilepsy (DRE) show impaired heart function and autonomic imbalance. This subclinical left ventricular (LV) dysfunction occurs even without long-term seizures, highlighting the need for cardiac monitoring in DRE patients.
Area of Science:
- Pediatric Neurology
- Cardiology
- Epilepsy Research
Background:
- Drug-resistant epilepsy (DRE) is linked to increased comorbidities and mortality.
- Cardio-autonomic imbalance and left ventricular (LV) dysfunction are significant risks in DRE.
- Understanding these cardiac issues is crucial for managing DRE patients.
Purpose of the Study:
- To determine the prevalence of LV dysfunction in children with DRE.
- To assess cardio-autonomic imbalance in pediatric DRE patients.
- To investigate the relationship between DRE and cardiac abnormalities.
Main Methods:
- Cross-sectional study comparing 40 children with DRE to 40 healthy controls.
- Echocardiography (M-mode, 2D, pulse-wave Doppler, TDI) assessed LV function.
- 24-hour Holter monitoring evaluated heart rate variability for cardio-autonomic function.
Main Results:
- Epilepsy group showed significantly altered heart rate variability parameters (lower time domain, lower HF, higher LF/HF ratio).
- Standard echocardiographic parameters for LV function were similar between groups.
- Tissue Doppler imaging revealed subclinical LV dysfunction in the DRE group (elevated MPI, IRT, E/Em).
Conclusions:
- Children with DRE exhibit significant cardio-autonomic dysfunction.
- Subclinical left ventricular dysfunction is present in pediatric DRE patients.
- Cardiac abnormalities in DRE are independent of epilepsy duration, seizure frequency, or type.
Background:
Resistance to antiepileptic drug treatment increases the risk of comorbidities and mortality due to a cardio-autonomic imbalance and left ventricular (LV) dysfunction.
Objective:
To assess the prevalence of LV dysfunction and cardio-autonomic imbalance in children with drug-resistant epilepsy (DRE).
Patients And Methods:
This cross-sectional study included 40 children with DRE and 40 healthy age- and sex-matched controls. LV function was evaluated by M-mode, two-dimensional, pulse-wave Doppler echocardiography, and tissue Doppler imaging (TDI). Cardio-autonomic function was assessed by 24 -h Holter monitoring of heart rate variability.
Results:
All time domain measures were significantly lower in the epilepsy group than in the control group (all Ps<0.01). Additionally, the mean high frequency (HF) parameters were significantly lower (P = 0.035), whereas the mean low frequency (LF) parameters and the LF/HF ratio were significantly higher (P < 0.001) in the epilepsy group than in the control group. LV function did not differ between groups regarding all standard echocardiographic parameters. There was evidence of subclinical LVdysfunction by tissue doppler among the epileptic group, as evidenced by the elevated Myocardial Performance Index, isovolumetric relaxation time and mitral E/Em ratio. There was no significant correlation between the duration of epilepsy or seizure frequency with any cardiac abnormality.
Conclusions:
Children with DRE exhibited cardio-autonomic and subclinical LV dysfunction, independent of the duration of epilepsy, frequency, and seizure type.
More Related Videos
08:28Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
Published on: April 5, 2011
11:54Simultaneous Video-EEG-ECG Monitoring to Identify Neurocardiac Dysfunction in Mouse Models of Epilepsy
Published on: January 29, 2018
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:26Heart Failure Drugs: Inotropic Agents
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Heart Failure II: Pathophysiology
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management