Cardiac Autonomic Dysfunction and Risk of ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Cardiac Autonomic Dysfunction and Risk of Sudden Unexpected Death in Epilepsy
Auteur(s) :
Szurhaj, W. [Auteur]
Leclancher, A. [Auteur]
Nica, A. [Auteur]
Périn, B. [Auteur]
Derambure, Philippe [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Convers, P. [Auteur]
Mazzola, L. [Auteur]
Godet, B. [Auteur]
Faucanie, M. [Auteur]
Picot, M. C. [Auteur]
De Jonckheere, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Leclancher, A. [Auteur]
Nica, A. [Auteur]
Périn, B. [Auteur]
Derambure, Philippe [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Convers, P. [Auteur]
Mazzola, L. [Auteur]
Godet, B. [Auteur]
Faucanie, M. [Auteur]
Picot, M. C. [Auteur]
De Jonckheere, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Titre de la revue :
Neurology
Nom court de la revue :
Neurology
Numéro :
96
Pagination :
e2619-e2626
Date de publication :
2021-05-25
ISSN :
1526-632X
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Objective
We aimed to test whether patients who died of sudden unexpected death in epilepsy (SUDEP) had an abnormal cardiac autonomic response to sympathetic stimulation by hyperventilation.
Methods
We conducted a ...
Lire la suite >Objective We aimed to test whether patients who died of sudden unexpected death in epilepsy (SUDEP) had an abnormal cardiac autonomic response to sympathetic stimulation by hyperventilation. Methods We conducted a retrospective, observational, case-control study of a group of patients who died of SUDEP and controls who were matched to the patients for epilepsy type, drug resistance, sex, age at EEG recording, age at onset of epilepsy, and duration of epilepsy. We analyzed the heart rate (HR) and HR variability (HRV) at rest and during and after hyperventilation performed during the patient's last EEG recording before SUDEP. In each group, changes over time in HRV indexes were analyzed with linear mixed models. Results Twenty patients were included in each group. In the control group, the HR increased and the root mean square of successive RR-interval differences (RMSSD) decreased during the hyperventilation and then returned to the baseline values. In the SUDEP group, however, the HR and RMSSD did not change significantly during or after hyperventilation. A difference in HR between the end of the hyperventilation and 4 minutes after its end discriminated well between patients with SUDEP and control patients (area under the receiver operating characteristic curve 0.870, sensitivity 85%, specificity 75%). Conclusion Most of patients with subsequent SUDEP have an abnormal cardiac autonomic response to sympathetic stimulation through hyperventilation. An index reflecting the change in HR on hyperventilation might be predictive of the risk of SUDEP and could be used to select patients at risk of SUDEP for inclusion in trials assessing protective measures.Lire moins >
Lire la suite >Objective We aimed to test whether patients who died of sudden unexpected death in epilepsy (SUDEP) had an abnormal cardiac autonomic response to sympathetic stimulation by hyperventilation. Methods We conducted a retrospective, observational, case-control study of a group of patients who died of SUDEP and controls who were matched to the patients for epilepsy type, drug resistance, sex, age at EEG recording, age at onset of epilepsy, and duration of epilepsy. We analyzed the heart rate (HR) and HR variability (HRV) at rest and during and after hyperventilation performed during the patient's last EEG recording before SUDEP. In each group, changes over time in HRV indexes were analyzed with linear mixed models. Results Twenty patients were included in each group. In the control group, the HR increased and the root mean square of successive RR-interval differences (RMSSD) decreased during the hyperventilation and then returned to the baseline values. In the SUDEP group, however, the HR and RMSSD did not change significantly during or after hyperventilation. A difference in HR between the end of the hyperventilation and 4 minutes after its end discriminated well between patients with SUDEP and control patients (area under the receiver operating characteristic curve 0.870, sensitivity 85%, specificity 75%). Conclusion Most of patients with subsequent SUDEP have an abnormal cardiac autonomic response to sympathetic stimulation through hyperventilation. An index reflecting the change in HR on hyperventilation might be predictive of the risk of SUDEP and could be used to select patients at risk of SUDEP for inclusion in trials assessing protective measures.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Université de Lille
CHU Lille
CHU Lille
Collections :
Date de dépôt :
2023-11-15T06:58:37Z
2024-01-31T09:08:46Z
2024-01-31T09:53:16Z
2024-02-27T14:59:14Z
2024-01-31T09:08:46Z
2024-01-31T09:53:16Z
2024-02-27T14:59:14Z