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Electrocardiographic Abnormalities and Mortality in Epilepsy Patients

Background and Objectives: People with epilepsy (PWE) have a 2–3 times higher mortality rate than the general population. Sudden unexpected death in epilepsy (SUDEP) comprises a significant proportion of premature deaths, whereas sudden cardiac death (SCD) is among the leading causes of sudden death...

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Autores principales: Suna, Normunds, Suna, Inga, Gutmane, Evija, Kande, Linda, Karelis, Guntis, Viksna, Ludmila, Folkmanis, Valdis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156797/
https://www.ncbi.nlm.nih.gov/pubmed/34065703
http://dx.doi.org/10.3390/medicina57050504
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author Suna, Normunds
Suna, Inga
Gutmane, Evija
Kande, Linda
Karelis, Guntis
Viksna, Ludmila
Folkmanis, Valdis
author_facet Suna, Normunds
Suna, Inga
Gutmane, Evija
Kande, Linda
Karelis, Guntis
Viksna, Ludmila
Folkmanis, Valdis
author_sort Suna, Normunds
collection PubMed
description Background and Objectives: People with epilepsy (PWE) have a 2–3 times higher mortality rate than the general population. Sudden unexpected death in epilepsy (SUDEP) comprises a significant proportion of premature deaths, whereas sudden cardiac death (SCD) is among the leading causes of sudden death in the general population. Cardiac pathologies are significantly more prevalent in PWE. Whether electrocardiographic (ECG) parameters are associated with remote death in PWE has yet to be elucidated. The study objective was to assess whether interictal ECG parameters are associated with mortality in the long-term. Materials and Methods: The study involved 471 epilepsy patients who were hospitalized after a bilateral tonic-clonic seizure(s). ECG parameters were obtained on the day of hospitalization (heart rate, PQ interval, QRS complex, QT interval, heart rate corrected QT interval (QTc), ST segment and T wave changes), as well as reported ECG abnormalities. Mortality data were obtained from the Latvian National Cause-of-Death database 3–11, mean 7.0 years after hospitalization. The association between the ECG parameters and the long-term clinical outcome were examined. Results: At the time of assessment, 75.4% of patients were alive and 24.6% were deceased. Short QTc interval (odds ratio (OR) 4.780; 95% confidence interval (CI) 1.668–13.698; p = 0.004) was associated with a remote death. After the exclusion of known comorbidities with high mortality rates, short QTc (OR 4.631) and ECG signs of left ventricular hypertrophy (OR 5.009) were associated with a remote death. Conclusions: The association between routine 12-lead rest ECG parameters—short QTc interval and a pattern of left ventricular hypertrophy—and remote death in epilepsy patients was found. To the best of our knowledge, this is the first study to associate rest ECG parameters with remote death in an epileptic population.
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spelling pubmed-81567972021-05-28 Electrocardiographic Abnormalities and Mortality in Epilepsy Patients Suna, Normunds Suna, Inga Gutmane, Evija Kande, Linda Karelis, Guntis Viksna, Ludmila Folkmanis, Valdis Medicina (Kaunas) Article Background and Objectives: People with epilepsy (PWE) have a 2–3 times higher mortality rate than the general population. Sudden unexpected death in epilepsy (SUDEP) comprises a significant proportion of premature deaths, whereas sudden cardiac death (SCD) is among the leading causes of sudden death in the general population. Cardiac pathologies are significantly more prevalent in PWE. Whether electrocardiographic (ECG) parameters are associated with remote death in PWE has yet to be elucidated. The study objective was to assess whether interictal ECG parameters are associated with mortality in the long-term. Materials and Methods: The study involved 471 epilepsy patients who were hospitalized after a bilateral tonic-clonic seizure(s). ECG parameters were obtained on the day of hospitalization (heart rate, PQ interval, QRS complex, QT interval, heart rate corrected QT interval (QTc), ST segment and T wave changes), as well as reported ECG abnormalities. Mortality data were obtained from the Latvian National Cause-of-Death database 3–11, mean 7.0 years after hospitalization. The association between the ECG parameters and the long-term clinical outcome were examined. Results: At the time of assessment, 75.4% of patients were alive and 24.6% were deceased. Short QTc interval (odds ratio (OR) 4.780; 95% confidence interval (CI) 1.668–13.698; p = 0.004) was associated with a remote death. After the exclusion of known comorbidities with high mortality rates, short QTc (OR 4.631) and ECG signs of left ventricular hypertrophy (OR 5.009) were associated with a remote death. Conclusions: The association between routine 12-lead rest ECG parameters—short QTc interval and a pattern of left ventricular hypertrophy—and remote death in epilepsy patients was found. To the best of our knowledge, this is the first study to associate rest ECG parameters with remote death in an epileptic population. MDPI 2021-05-16 /pmc/articles/PMC8156797/ /pubmed/34065703 http://dx.doi.org/10.3390/medicina57050504 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Suna, Normunds
Suna, Inga
Gutmane, Evija
Kande, Linda
Karelis, Guntis
Viksna, Ludmila
Folkmanis, Valdis
Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
title Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
title_full Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
title_fullStr Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
title_full_unstemmed Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
title_short Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
title_sort electrocardiographic abnormalities and mortality in epilepsy patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156797/
https://www.ncbi.nlm.nih.gov/pubmed/34065703
http://dx.doi.org/10.3390/medicina57050504
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