Heart type fatty acid binding protein, a marker of myocardial ischemia in children with epilepsy

Abstract

To evaluate ictal serum levels of heart type fatty acid binding protein (H-FABP) in children with intractable epilepsy as a marker of cardiac ischemia in comparison to their levels in the interictal period and that of controls. The study included 23 seizure episodes recorded in 14 patients with intractable seizures. Serum levels of H-FABP in the ictal and interictal periods were done as well as simultaneous electrocardiogram, Holter and video electroencephalography recordings with evaluation of changes in the heart rate (HR), and HR variability parameters. Levels of H-FABP were higher in the patients' group whether in the ictal or interictal periods compared to the control group. However, levels were not significantly different in the ictal period compared to the interictal one. Ictal tachycardia was recorded in 95% and bradycardia in 5% of the studied seizures episodes. Premature atrial and ventricular contractions were recorded in the 1st postictal hour of 8.7% and 30.4% of the recorded seizures, respectively. Interictal values showed significant increase minutes before the onset of the seizures and remained high 2 hours postictally. All time domain HR variability parameters were lower in the patients' group. Our results showed significant increase in the serum levels of H-FABP in our patients' group, which might suggest a degree of myocardial ischemia even in asymptomatic patients. Though bradycardia, prolonged QTc and arrhythmic changes were reported in few cases, the importance of the results warrants studying those changes at least in patients with refractory seizures.

Heart-type fatty acid-binding protein as a predictor of cardiac ischemia in intractable seizures in children

“…Similar findings were recorded by other authors. [82730] Bradycardia and bradyarrhythmia are much less frequent and are seen in seizures of various origins. Factors predisposing patients to ictal bradyarrhythmia remain difficult to define.…”

“…Our findings were supported by the results of the previous studies. [132731] The cardiac effects of epilepsy are widespread and range from subtle changes in HRV to ictal sinus arrest. HRV reflects the beat-to-beat alterations in the HR and is mainly modulated by the parasympathetic and sympathetic activity.…”

“…This was in agreement of Tomoum et al ., who reported similar findings. [27] Contradictory results reported that QTc values were increased in epileptic patients compared to that in the control group. [40] Furthermore, other researchers found a statistically significant prolongation of QTc in association with epileptic discharges in EEG.…”