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Left ventricle end‐systolic elastance, arterial‐effective elastance, and ventricle‐arterial coupling in Epilepsy
Author(s) -
Fialho Guilherme L.,
Wolf Peter,
Walz Roger,
Lin Katia
Publication year - 2021
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13334
Subject(s) - cardiology , medicine , ventricle , afterload , blood pressure , epilepsy , sudden death , psychiatry
Objective Sudden unexpected death in epilepsy (SUDEP) is a tragic event. Cardiac models of sudden death state that, paradoxically, healthy individuals compose most of the victims of this event. Exploration of cardiac physiological variables related to outcome could help unveil risk markers for sudden death in epilepsy. We investigated left ventricle end‐systolic elastance, arterial‐effective elastance and ventricle‐arterial coupling (VAC) in PWE compared with controls. Material & Methods Adult patients with temporal lobe epilepsy without known cardiovascular diseases were submitted to treadmill test and transthoracic echocardiogram. Individuals without epilepsy matched by sex, age, and body mass index composed the control group. Cardiac risk factors, exercise performance, autonomic data from treadmill test, systolic and diastolic function, morphological cardiac data, and left ventricle pressure‐volume loop were recorded. Results Sixty subjects were consecutively enrolled (30 PWE and 30 controls). Epilepsy duration was 22.5 ± 10.7 years (age of onset 15.2 ± 10.1 years). Treadmill variables were significantly worse in TLE patients compared with controls. End‐systolic elastance, arterial‐effective elastance, and ventricle‐arterial coupling were similar between groups. Female sex, percentage of maximal predicted heart rate achieved in exercise, exercise time, and epilepsy duration explained 28,4% of VAC in PWE in multiple stepwise linear regression ( P = .018). Conclusions Some aspects of the cardiac pressure‐volume curves, mainly linked to left ventricle systolic performance, contractile function and their interaction with afterload appears normal in young PWE and cannot explain their increase risk to adverse outcomes or lower physical fitness.