Cardiac structural and functional abnormalities in epilepsy: A systematic review and meta-analysis
Zining Liu1, Peravina Thergarajan1, Ana Antonic-Baker1
1Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Epilepsia Open
|January 17, 2023
Summary
Epilepsy patients show altered cardiac function, including reduced left ventricular ejection fraction. Sudden unexpected death in epilepsy (SUDEP) cases do not exhibit increased structural heart abnormalities compared to other epilepsy patients.
Area of Science:
- Cardiology
- Neurology
Background:
- Epilepsy is linked to increased cardiovascular disease and mortality risk.
- The impact of epilepsy on cardiac structure and function requires clarification.
Approach:
- A systematic review and meta-analysis evaluated cardiac structure and function in epilepsy patients.
- Studies were identified through searches of MEDLINE, PubMed, COCHRANE, and Web of Science up to December 31, 2021.
- Primary outcomes included left ventricular ejection fraction (LVEF) from echocardiograms and postmortem cardiac weight and fibrosis.
Key Points:
- Epilepsy patients had significantly decreased LVEF compared to controls.
- Elevated A-wave velocity, E/e' ratio, and isovolumic relaxation time were observed in epilepsy patients.
- No significant differences in cardiac hypertrophy, heart weight, or fibrosis were found between SUDEP cases and epilepsy controls.
Conclusions:
- Epilepsy is associated with altered systolic and diastolic cardiac function detected by echocardiography.
- Sudden unexpected death in epilepsy (SUDEP) is not linked to a higher prevalence of structural cardiac abnormalities.
- Further longitudinal studies are recommended to assess the prognostic value of these cardiac changes.
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