The epileptic heart: Cardiac comorbidities and complications of epilepsy. Atrial and ventricular structure and function by echocardiography in individuals with epilepsy – From clinical implications to individualized assessment

• Published in: Epilepsy & behavior reports Vol. 26; p. 100668
• Main Authors: Loureiro Fialho, Guilherme, Miotto, Ramsés, Tatsch Cavagnollo, Márcia, Murilo Melo, Hiago, Wolf, Peter, Walz, Roger, Lin, Katia
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2024; Elsevier
• Subjects: Atrial fibrillation; Echocardiography; Epilepsy; Heart; Myocardial strain; Heart; Echocardiography; Myocardial strain; Epilepsy; Atrial fibrillation
• ISSN: 2589-9864; 2589-9864
• DOI: 10.1016/j.ebr.2024.100668

•Epidemiological and mechanistic studies have linked cardiac risk to epilepsy.•Arrhythmias, myocardial infarction, heart failure, and sudden death affect PWE.•Echocardiography is a tool to analyze cardiac structure and function.•The full potential of new echocardiographic technology has not been explored in PWE.•Risk stratification should evolve to better select individuals with epilepsy at risk. Epilepsy is an increasing global neurological health issue. Recently,epidemiological and mechanistic studies have raised concern about cardiac involvement in individuals with epilepsy. This has resulted in the “epileptic heart” concept. Epidemiological data linking epilepsy to cardiovascular disease indicate an increased risk for ventricular and atrial arrhythmias, myocardial infarction, heart failure, and sudden death among individuals with epilepsy. Pathways of this interaction comprise increased prevalence of traditional cardiac risk factors, genetic abnormalities, altered brain circuitry with autonomic imbalance, and antiseizure medications with enzyme-inducing and ionic channel-blocking proprieties. Pathophysiological findings in the atria and ventricles of patients with epilepsy are discussed. Echocardiographic findings and future applications of this tool are reviewed. A risk stratification model and future studies on cardiac risk assessment in individuals with epilepsy are proposed.