Serum Levels of Cardiac Troponin I in Patients with Uncomplicated Epileptic Seizure

Hajsadeghi, Shokoufeh; Afsharian, Shila; Fereshtehnejad, Seyed‐Mohammad; Keramati, Mohammad Reza; Mollahoseini, Reza

doi:10.1016/j.arcmed.2008.10.002

Cited by 24 publications

(22 citation statements)

References 37 publications

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“…The results also indicate that the degree of troponin elevation is independently associated with the number of seizures experienced and the age of the dog. These results are similar to those from a study of human patients which demonstrated that cTnI concentration increased with increased seizure number (Hajsadeghi et al . 2009 ).…”

Section: Discussionsupporting

confidence: 91%

“…These results are similar to those from a study of human patients which demonstrated that cTnI concentration increased with increased seizure number (Hajsadeghi et al . ). Myocardial injury in the setting of seizure activity could be expected given the apnoea, tachycardia, increased myocardial oxygen consumption and excess catecholamine release associated with seizures, which has been observed in experimental rat models (Metcalf et al .…”

Section: Discussionmentioning

confidence: 97%

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Serum cardiac troponin I concentrations in dogs with generalised seizures

Dutton

Carmichael²,

Michal

et al. 2017

J of Small Animal Practice

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 97%

Serum cardiac troponin I concentrations in dogs with generalised seizures

Dutton

Carmichael²,

Michal

et al. 2017

J of Small Animal Practice

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“…In one analytic cross-sectional study, cardiac troponin I following seizure was within the normal limits in 49 patients with uncomplicated epileptic seizures and healthy cardiovascular systems 15). No elevation in cardiac troponins levels was seen in 11 patients after monitored seizure, indicating that myocardial injury does not occur during uncomplicated seizure 16).…”

Section: Discussionmentioning

confidence: 97%

Type 2 Myocardial Infarction Following Generalized Tonic-Clonic Seizure

et al. 2011

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Myocardial infarction is diagnosed when blood levels of biomarkers are increased in the clinical setting of acute myocardial ischemia. Among the biomarkers, troponin I is the preferred biomarker indicative of myocardial necrosis. It is tissue specific for the heart. Myocardial infarction is rarely reported following seizure. We report a case of elevated troponin I in a patient after an episode of generalized tonic-clonic seizure. The diagnosis was type 2 myocardial infarction.

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“…Cardiac sympathetic tone is significantly heightened during seizures, as indicated by HRV studies . In patients with epilepsy, repeated seizure‐induced hypoxemia and increased catecholamine and troponin I levels have been reported and postulated as the basis for pathologic substrate changes, including myocardial fibrosis, dilation, degeneration, and infarction . These changes could constitute a substrate for myocardial ischemia and ventricular tachycardia and fibrillation, the arrhythmia responsible for sudden cardiac death in patients with cardiovascular disease .…”

Section: Discussionmentioning

confidence: 99%

Vagus nerve stimulation reduces cardiac electrical instability assessed by quantitative T‐wave alternans analysis in patients with drug‐resistant focal epilepsy

et al. 2014

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SUMMARYObjective: The cardiac component of risk for sudden unexpected death in epilepsy (SUDEP) and alterations in cardiac risk by vagus nerve stimulation (VNS) are not well understood. We determined changes in T-wave alternans (TWA), a proven noninvasive marker of risk for sudden cardiac death in patients with cardiovascular disease, and heart rate variability (HRV), an indicator of autonomic function, in association with VNS in patients with drug-resistant focal epilepsy. Methods: Ambulatory 24-h electrocardiograms (N = 9: ages 29-63, six males) were analyzed. Results: Mean TWA during the interictal period was 37 AE 3.1 lV (mean AE SEM) in lead V 1 for nine patients monitored following implantation of the VNS system (n = 7) or battery change (n = 2). Of these, six patients also monitored prior to implantation (n = 5) or battery change (n = 1) showed abnormally high TWA levels pre-VNS (60.0 AE 4.3 lV), which were significantly reduced by 24.3 lV (to 35.7 AE 4.8 lV, p = 0.02) after VNS settings were adjusted for desired clinical response. TWA in four (67%) of the six patients was reduced in association with VNS to levels below the 47-lV cut point of abnormality. The decrease in TWA was correlated with VNS intensity (r = 0.88, p < 0.02). In addition, low-frequency HRV was reduced by 60% (805.61 AE 253.96 to 323.49 AE 102.74 msec 2 , p = 0.05) and low-to high-frequency HRV ratio by 32% (3.34 AE 0.57 to 2.26 AE 0.31, p = 0.025), indicating a change in autonomic balance in favor of parasympathetic dominance. Significance: This is the first report that elevated levels of TWA in patients with drugrefractory partial-onset seizures were reduced in association with VNS, potentially by improving sympathetic/parasympathetic balance. VNS may have a cardioprotective role at stimulation settings typically used for seizure control. These findings indicate the utility of TWA for tracking improvement in cardiac status in this population. KEY WORDS: Vagus nerve stimulation, T-wave alternans, Heart rate variability, Sudden unexpected death in epilepsy.

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Serum Levels of Cardiac Troponin I in Patients with Uncomplicated Epileptic Seizure

Cited by 24 publications

References 37 publications

Serum cardiac troponin I concentrations in dogs with generalised seizures

Serum cardiac troponin I concentrations in dogs with generalised seizures

Type 2 Myocardial Infarction Following Generalized Tonic-Clonic Seizure

Vagus nerve stimulation reduces cardiac electrical instability assessed by quantitative T‐wave alternans analysis in patients with drug‐resistant focal epilepsy

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