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Published on: January 29, 2018
Ketogenic diet enhances cardiac autonomic stability in pediatric drug-resistant epilepsy: A longitudinal heart rate
Nazlı Balcan Karaca1, Akif Kavgacı2, Semiha Terlemez2
1Department of Pediatric Neurology, Ankara Training and Research Hospital, Ankara, Turkey.
Insights
Ketogenic diet therapy improved cardiac autonomic regulation in children with drug-resistant epilepsy, evidenced by increased heart rate variability (HRV) metrics like SDNN and minimum heart rate. This suggests potential benefits for autonomic function in pediatric epilepsy patients.
Area of Science:
- Pediatric Neurology
- Cardiology
- Metabolic Therapies
Background:
- Pediatric drug-resistant epilepsy (DRE) is linked to autonomic dysregulation, increasing cardiovascular risks.
- Understanding interventions that can mitigate these risks is crucial for improving patient outcomes.
Purpose of the Study:
- To assess the impact of ketogenic diet (KD) therapy on cardiac autonomic regulation in children with DRE.
- To evaluate changes in heart rate variability (HRV) metrics as indicators of autonomic function.
Main Methods:
- A prospective longitudinal observational study involving 13 pediatric patients with DRE.
- 24-hour ambulatory ECG (Holter) monitoring was conducted at baseline and after six months of KD therapy.
- Time-domain HRV parameters (SDNN, SDANN, RMSSD, pNN50) were analyzed, alongside heart rate dynamics and arrhythmia assessment.
Main Results:
- Ketogenic diet therapy led to a statistically significant increase in SDNN (105.77 ± 44.11 ms to 127.38 ± 37.70 ms, p=0.0479), indicating improved global autonomic tonus.
- A significant stabilization of minimum heart rate was observed (42.46 ± 27.07 bpm to 60.31 ± 26.20 bpm, p=0.0314).
- No significant arrhythmias or conduction abnormalities were detected, confirming cardiac safety.
Conclusions:
- Ketogenic diet therapy demonstrated selective improvements in cardiac autonomic parameters, specifically SDNN and minimum heart rate, in children with DRE.
- These findings suggest ketosis may positively influence autonomic regulation in pediatric epilepsy.
- Further research with larger sample sizes and control groups is warranted to confirm these preliminary results.
Objective:
Pediatric drug-resistant epilepsy(DRE) is frequently associated with autonomic dysregulation, which contributes to increased cardiovascular morbidity. This study evaluated the impact of a ketogenic diet(KD) therapy on cardiac autonomic regulation in children with DRE using heart rate variability(HRV) metrics.
Methods:
In this prospective longitudinal observational study, 13 pediatric patients with DRE were enrolled.All patients underwent 24-hour ambulatory ECG (Holter) monitoring at baseline and after six months of ketosis.Time-domain HRV parameters (SDNN,SDANN,RMSSD, pNN50) and heart rate dynamics were analyzed. A blinded pediatric cardiologist performed a comprehensive arrhythmia analysis to ensure cardiac safety.
Results:
Following six months of KD therapy, a statistically significant increase was observed in SDNN,rising from 105.77 ± 44.11 ms to 127.38 ± 37.70 ms(p=0.0479), indicating an enhancement in global autonomic tonus and homeostatic resilience. Additionally, the minimum heart rate exhibited a significant stabilization, increasing from 42.46 ± 27.07 bpm to 60.31 ± 26.20 bpm(p = 0.0314).Other HRV parameters showed upward numerical trends but did not reach statistical significance.No clinically significant arrhythmias or conduction abnormalities were detected, confirming a favorable cardiac safety profile.
Conclusion:
In this exploratory longitudinal study, ketogenic diet therapy was associated with selective improvements in cardiac autonomic parameters,particularly increased SDNN and minimum heart rate,in children with drug-resistant epilepsy.These findings provide preliminary evidence that ketosis may favorably influence autonomic regulation in this population. However, given the limited sample size and the absence of a control group,the results should be interpreted with caution and should not be considered definitive.More research is needed to confirm these observations and define the clinical value of HRV monitoring during ketogenic diet therapy.
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