This study aims to explore the relationship between epilepsy and the occurrence of "epileptic heart" in patients from the Adult Neurology Unit of NMC 20 de Noviembre, Mexico.
Cardiovascular disease affects 21% of epilepsy patients, a notably higher rate than in the general population. The term "epileptic heart" describes heart and coronary artery damage caused by chronic epilepsy. Factors such as seizure frequency, polytherapy, and certain anti-seizure medications (ASMs) can determine the risk for epileptic heart. Diagnosis of "epileptic heart" requires chronic epilepsy, with or without drug resistance, plus two additional criteria, such as electrocardiographic or echocardiographic abnormalities and/or an altered lipid profile.
This cross-sectional, observational, and analytical study included adult epilepsy patients at NMC 20 de Noviembre. Cardiac assessments, including EKGs, echocardiograms, and atherogenic index evaluations, were performed to detect abnormalities. Patients were categorized based on seizure control, considering type, frequency, and the number of ASMs used. Statistical analyses, such as Pearson correlation, were used to assess the relationship between epilepsy characteristics and cardiac dysfunction.
The study involved 49 patients (n=23/47% women, n=26/53% men), with 44 (90%) having drug-resistant epilepsy. Age at seizure onset correlated with left ventricular stiffness and diastolic dysfunction (0.389, p<0.01), while years since diagnosis negatively correlated with left ventricular E/A ratio (-0.397, p<0.01) and left atrial strain (-0.471, p<0.01). EKG abnormalities included prolonged QT intervals in 9 (18%) patients and widened QRS complexes in 2. Echocardiograms revealed increased left ventricular stiffness in 1 patient and reduced left atrial strain in 11 (23%). Additionally, 24 patients (49%) had elevated triglycerides, 25 (51%) low HDL, and 14 (29%) exhibited high atherogenic risk.
The findings suggest a strong link between poorly controlled epilepsy, particularly in patients on polytherapy, and cardiac abnormalities. Routine cardiac monitoring is recommended to reduce cardiovascular risks in epilepsy patients.