Subtle Right Ventricular Myocardial Dysfunction in Children with Refractory Epilepsy using 2-D speckle tracking echocardiography

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Eman Rashed zaky , Marwa Elhady , Ahmed Helal Elsayed , Mahmoud M Zahran , Rasha Sobhy Elattar , Eman A. Elhamrawy

Abstract

Objective: Recent echocardiographic modalities can detect subclinical structural and functional myocardial changes allow early prediction of those at high risk for adverse cardiac events. This study aimed to evaluate right ventricle (RV) function in children with refractory epilepsy and its relation to clinical characteristics of epilepsy.


Methods: Forty children with refractory epilepsy and 40 age and sex matched healthy children were enrolled. Clinical, electroencephalographic characteristics and seizure severity score were determined.  RV function was assessed using conventional echocardiography, tissue Doppler and speckle tracking modalities.


Results: Despite preserved ejection fraction, children with refractory epilepsy have significant higher RV end systolic dimension. RV tissue Doppler imaging and speckle tracking parameters revealed statistically significant higher RV myocardial performance index and significant lower RV global strain in children with refractory epilepsy than healthy control. The younger age of onset, the longer duration of epilepsy and the higher scores of epilepsy severity were significantly associated with worse right ventricular performance.


In conclusion, children with refractory epilepsy had subtle RV systolic and diastolic dysfunction that correlated to the duration and severity of epilepsy. Speckle tracking modality of echocardiography provides simple efficient tool for early detection of subclinical RV dysfunction in children with epilepsy.

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