Strain analysis of cardiac chambers in individuals with temporal lobe epilepsy

Cardiovascular impairment in people with epilepsy (PWE) has been attracting medical interest. This study investigated the myocardial strain of the four cardiac chambers of individuals with temporal lobe epilepsy, without known heart disease, compared to an age-, sex-, and body mass index-matched control group. Eighty-six individuals (43 with epilepsy and 43 controls) underwent clinical evaluation, electrocardiography, and transthoracic echocardiography. Individuals with epilepsy had reduced left ventricular ejection fraction (p = .001), left ventricular longitudinal strain (p = .011), right ventricular strain (p = .024), left atrial biplanar contractile strain (p = .009), and right atrial reservoir (p = .0001), conduit (p = .025), and contractile strain (p = .0003). In multivariate analysis, epilepsy was a predictor of reduced contractile and reservoir strain values of both atria. Among individuals with epilepsy, polytherapy with antiseizure medications was an independent predictor of reduced left ventricular global longitudinal strain. Disease duration was an independent predictor of reduced left and right atrial reservoir strain and right atrial contractile strain. These data suggest subtle and early cardiac involvement in PWE and could help clarify the increased incidence of cardiac events in this population.