Persson Håkan, Ericson M, Tomson T
Department of Clinical Neuroscience, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden.
Seizure. 2007 Sep;16(6):504-8. doi: 10.1016/j.seizure.2007.03.010. Epub 2007 May 9.
Several studies have reported reduced heart rate variability (HRV) in patients with chronic epilepsy under treatment with antiepileptic drugs. This impairment in cardiac autonomic control might be of relevance in relation to the risk of sudden unexpected death in patients with chronic refractory epilepsy. Little information is, however, available on HRV in untreated patients with newly diagnosed epilepsy.
We used spectral analysis to assess HRV based on 24h ambulatory EKG recordings in 22 consecutive untreated patients with epilepsy (15 with localization-related, 4 with generalized idiopathic and 3 with undetermined epilepsy). The HRV in these patients was compared with 22 age and sex matched healthy controls.
When analysing the full 24h recordings, there were no significant difference between the patients and the controls in any of the analyzed measures of HRV: standard deviation of RR-intervals (P=0.191), total power (P=0.170), very low frequency power (P=0.329), low frequency power (LF) (P=0.161), high frequency power (HF) (P=0.186) and the LF/HF ratio (P=0.472). The results were very similar for daytime and nighttime recordings.
Our results suggest that there is no major effect of epilepsy as such on HRV in patients with untreated epilepsy. It should be emphasized that this study assessed newly diagnosed patients and that the results may not be applicable to patients with chronic epilepsy.
多项研究报告称,接受抗癫痫药物治疗的慢性癫痫患者心率变异性(HRV)降低。心脏自主神经控制的这种损害可能与慢性难治性癫痫患者突然意外死亡的风险有关。然而,关于新诊断未治疗癫痫患者的HRV的信息很少。
我们对22例连续的未经治疗的癫痫患者(15例局灶性相关癫痫、4例全身性特发性癫痫和3例癫痫类型未确定患者)进行24小时动态心电图记录,并采用频谱分析评估HRV。将这些患者的HRV与22名年龄和性别匹配的健康对照者进行比较。
分析完整的24小时记录时,患者与对照者在任何分析的HRV指标上均无显著差异:RR间期标准差(P = 0.191)、总功率(P = 0.170)、极低频功率(P = 0.329)、低频功率(LF)(P = 0.161)、高频功率(HF)(P = 0.186)和LF/HF比值(P = 0.472)。白天和夜间记录的结果非常相似。
我们的结果表明,癫痫本身对未经治疗的癫痫患者的HRV没有重大影响。应该强调的是,本研究评估的是新诊断患者,结果可能不适用于慢性癫痫患者。