ArticleAnnals of pediatric cardiology
Changes in serum cardiac troponin I after seizures: A marker for persistent subtle left ventricular myocardial dysfunctions in children with epilepsy.
Article in Annals of pediatric cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Epilepsy is a common neurological disease in childhood. There is a widespread association of epilepsy with cardiovascular comorbidities. Therefore, the study aimed to assess left ventricular (LV) myocardial dysfunction in children with epilepsy using serum cardiac troponin I (cTnI) and various echocardiographic modalities. Methods: The study was a prospective case-control study including 55 children diagnosed with epilepsy and 40 controls. Serum cTnI was measured in patients (12-24 h after seizure) and repeated after 4 weeks. Detailed conventional echocardiography with tissue Doppler imaging (TDI) and two-dimensional speckle tracking echocardiography (2D-STE) was performed in patients with elevated basal cTnI, and the echocardiographic parameters were re-evaluated after 4 weeks. Results: Out of 55 children with epilepsy, cTnI was increased in 15 (27.5%). On postseizure echocardiography, LV diameters were significantly increased compared with controls; however, no other conventional parameters showed a significant difference. TDI-derived E/e' ratio, s' velocity, and myocardial performance index were significantly affected compared to healthy children. 2D-STE measured global longitudinal strain (GLS) and global circumferential strain (GCS) were significantly decreased in patients compared with controls. The s' velocity, GLS, and GCS were negatively correlated with cTnI level with ( Conclusions: Postseizure serum cTnI is a valuable marker of persistent, subtle LV myocardial changes in epileptic children, especially TDI and 2D-STE-derived parameters. The normalization of cTnI is an indicator of the myocardial stunning process in children that would lead to persistent LV myocardial injury following recurrence of seizure, which warrants strict seizure control and cardiac surveillance.
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