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Background <p>Pediatric epilepsy may adversely affect cardiac function. This study examined cardiac outcomes in children with controlled and drug-resistant epilepsy (DRE).</p> Methods <p>Sixty children with epilepsy (30 DRE, 30 drug-responsive) and 30 healthy controls underwent 12-lead ECG, M-mode echocardiography, and speckle tracking echocardiography (STE) to assess cardiac electrical activity, left ventricular (LV) volumes, ejection fraction (EF), fractional shortening (FS), and global longitudinal strain (GLS).</p> Results <p>ECG findings were comparable among the three groups. LV end-diastolic (LVEDV) and end-systolic volumes (LVESV), FS, and EF were significantly lower in DRE vs. controls (<i>p</i> &lt; 0.05). LVEDV and EF were significantly lower in DRE vs. drug-responsive epilepsy (<i>p</i> &lt; 0.05), while drug-responsive cases had lower LVEDV vs. controls (<i>p</i> = 0.015). LV GLS was significantly lower in DRE (−19.34 ± 1.80) vs. drug-responsive epilepsy (−20.33 ± 1.45) (<i>p</i> = 0.023) and controls (−20.58 ± 0.91) (<i>p</i> = 0.003). LV GLS correlated positively with time since last seizure (<i>p</i> = 0.007) and negatively with the number of antiseizure medications (<i>p</i> = 0.007).</p> Conclusions <p>Children with DRE exhibit significant cardiac dysfunction. STE enables early detection of subclinical cardiac abnormalities in DRE, advocating for its integration into routine monitoring.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Compares cardiac function in pediatric drug-resistant epilepsy (DRE) and drug-responsive epilepsy, identifying impaired systolic function and global longitudinal strain (GLS) in DRE.</p> </ItemContent> <ItemContent> <p>Correlates GLS abnormalities with antiseizure medication burden and time since last seizure, linking cardiac dysfunction to treatment intensity and epilepsy disease course.</p> </ItemContent> <ItemContent> <p>Advocates STE for early cardiac monitoring in DRE and urges longitudinal studies to disentangle epilepsy-related cardiovascular risks from drug-driven effects.</p> </ItemContent> </UnorderedList></p>

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Subclinical cardiac dysfunction detected by speckle-tracking echocardiography in children with drug-resistant epilepsy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月3日

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  • Mahmoud M. Noureldeen,
  • Mohamed Mabrouk Tohamy,
  • Osama Ezzat Botrous,
  • Fatma Hussein Shaker

摘要

Background

Pediatric epilepsy may adversely affect cardiac function. This study examined cardiac outcomes in children with controlled and drug-resistant epilepsy (DRE).

Methods

Sixty children with epilepsy (30 DRE, 30 drug-responsive) and 30 healthy controls underwent 12-lead ECG, M-mode echocardiography, and speckle tracking echocardiography (STE) to assess cardiac electrical activity, left ventricular (LV) volumes, ejection fraction (EF), fractional shortening (FS), and global longitudinal strain (GLS).

Results

ECG findings were comparable among the three groups. LV end-diastolic (LVEDV) and end-systolic volumes (LVESV), FS, and EF were significantly lower in DRE vs. controls (p < 0.05). LVEDV and EF were significantly lower in DRE vs. drug-responsive epilepsy (p < 0.05), while drug-responsive cases had lower LVEDV vs. controls (p = 0.015). LV GLS was significantly lower in DRE (−19.34 ± 1.80) vs. drug-responsive epilepsy (−20.33 ± 1.45) (p = 0.023) and controls (−20.58 ± 0.91) (p = 0.003). LV GLS correlated positively with time since last seizure (p = 0.007) and negatively with the number of antiseizure medications (p = 0.007).

Conclusions

Children with DRE exhibit significant cardiac dysfunction. STE enables early detection of subclinical cardiac abnormalities in DRE, advocating for its integration into routine monitoring.

Impact

Compares cardiac function in pediatric drug-resistant epilepsy (DRE) and drug-responsive epilepsy, identifying impaired systolic function and global longitudinal strain (GLS) in DRE.

Correlates GLS abnormalities with antiseizure medication burden and time since last seizure, linking cardiac dysfunction to treatment intensity and epilepsy disease course.

Advocates STE for early cardiac monitoring in DRE and urges longitudinal studies to disentangle epilepsy-related cardiovascular risks from drug-driven effects.