Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
<i>Background and Objectives</i>: 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 cau...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-05-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/57/5/504 |
| _version_ | 1797533909043380224 |
|---|---|
| author | Normunds Suna Inga Suna Evija Gutmane Linda Kande Guntis Karelis Ludmila Viksna Valdis Folkmanis |
| author_facet | Normunds Suna Inga Suna Evija Gutmane Linda Kande Guntis Karelis Ludmila Viksna Valdis Folkmanis |
| author_sort | Normunds Suna |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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; <i>p</i> = 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. <i>Conclusions:</i> 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. |
| first_indexed | 2024-03-10T11:22:21Z |
| format | Article |
| id | doaj.art-c7b4f4821e884272b8b2a5b3025d538e |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T11:22:21Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-c7b4f4821e884272b8b2a5b3025d538e2023-11-21T19:58:05ZengMDPI AGMedicina1010-660X1648-91442021-05-0157550410.3390/medicina57050504Electrocardiographic Abnormalities and Mortality in Epilepsy PatientsNormunds Suna0Inga Suna1Evija Gutmane2Linda Kande3Guntis Karelis4Ludmila Viksna5Valdis Folkmanis6Department of Infectology, Riga Stradins University, 3 Linezera St., LV-1006 Riga, LatviaDepartment of Neurology and Neurosurgery, Riga East Clinical University Hospital “Gailezers”, 2 Hipokrata St., LV-1039 Riga, LatviaFaculty of Residency, Riga Stradins University, 16 Dzirciema St., LV-1007 Riga, LatviaFaculty of Residency, Riga Stradins University, 16 Dzirciema St., LV-1007 Riga, LatviaDepartment of Infectology, Riga Stradins University, 3 Linezera St., LV-1006 Riga, LatviaDepartment of Infectology, Riga Stradins University, 3 Linezera St., LV-1006 Riga, LatviaFaculty of Medicine, University of Latvia, 19 Raina Blvd., LV-1586 Riga, Latvia<i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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; <i>p</i> = 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. <i>Conclusions:</i> 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.https://www.mdpi.com/1648-9144/57/5/504sudden cardiac death risk markersepilepsyshort QTelectrocardiographic parametersleft ventricular hypertrophydeath in epilepsy |
| spellingShingle | Normunds Suna Inga Suna Evija Gutmane Linda Kande Guntis Karelis Ludmila Viksna Valdis Folkmanis Electrocardiographic Abnormalities and Mortality in Epilepsy Patients Medicina sudden cardiac death risk markers epilepsy short QT electrocardiographic parameters left ventricular hypertrophy death in epilepsy |
| 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 | sudden cardiac death risk markers epilepsy short QT electrocardiographic parameters left ventricular hypertrophy death in epilepsy |
| url | https://www.mdpi.com/1648-9144/57/5/504 |
| work_keys_str_mv | AT normundssuna electrocardiographicabnormalitiesandmortalityinepilepsypatients AT ingasuna electrocardiographicabnormalitiesandmortalityinepilepsypatients AT evijagutmane electrocardiographicabnormalitiesandmortalityinepilepsypatients AT lindakande electrocardiographicabnormalitiesandmortalityinepilepsypatients AT guntiskarelis electrocardiographicabnormalitiesandmortalityinepilepsypatients AT ludmilaviksna electrocardiographicabnormalitiesandmortalityinepilepsypatients AT valdisfolkmanis electrocardiographicabnormalitiesandmortalityinepilepsypatients |