Evaluation and Risk Factors of Cardiac Electrical and Autonomic Function in Children With Dravet Syndrome
Abstract number :
1.242
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2018
Submission ID :
497071
Source :
www.aesnet.org
Presentation date :
12/1/2018 6:00:00 PM
Published date :
Nov 5, 2018, 18:00 PM
Authors :
Yun-Jin Lee, Pusan National University Children’s Hospital; Geena Kim, Pusan National University Children’s Hospital; JuHyun Kong, Pusan National University Children’s Hospital; Ara Ko, Pusan National University Children’s Hospital
Rationale: Because of the presence of epileptic syndromes caused by ion channel mutations, recent reports have speculated on a pathogenic link between neuronal and cardiac channelopathies that could clarify the high incidence of SUDEP. Dravet syndrome (DS) patients were found to have the abnormal heart rate variability (HRV), pointing to a connection between cardiac autonomic dysfunction and SUDEP, compared to both healthy children. This aim is to investigate the cardiac electrical and autonomic function and the risk factors in children with DS. Methods: Seventeen children with DS (9 boys, 8 girls, mean age 7.1 ± 2.8 years) and 15 control subjects (7 boys, 8 girls, mean age 8.0 ± 3.1 years) were enrolled in this study. P-dispersion, QTc- and QTc-dispersion, and HRV were evaluated using standard electrocardiography (ECG) and 24hr Holter ECG monitoring in two groups. Results: DS-group had significantly higher values of the QT- and QTc-dispersion (p <0.001 for two parameters) than the control-group. Most HRV parameters, such as SDNN (p <0.001), SDANN5 (p <0.001), SDANN-index (p=0.001), and RMSSD (p=0.028) were all significantly lower in DS-group than in control-group. In DS-group, the duration of epilepsy and number of antiepileptic drugs (AEDs) had positively correlated with QTc, and QT- and QTc dispersion, and inversely correlated with most HRV parameters. Seizure frequency showed positively correlated with QT dispersion, and inversely correlated with SDNN, SDANN5, and SDANN-index. In the multivariate regression, epilepsy duration of =5 years were independently associated with QTc (p=0.006) and QTc dispersion (p=0.045), and RMSSD (p=0.046). Number of AEDs (p=0.006) and seizure frequency (p=0.017) were significantly associated with SNDD and SDANN-index, respectively. Conclusions: The decreased HRV and increased QT- and QTc-dispersion seen in DS-group are significant signs of imbalance of cardiac autonomic function with increased adrenergic tone. Particularly, duration of epilepsy, number of AEDs and frequent seizures negatively affected them of DS-group. Funding: This study was supported by Research Institute for Convergence of Biomedical Science and Technology Grant (30-2015-019), Pusan National University Yangsan Hospital.