Articles

Effect of Sodium Valproate on Cardiac Function in Epileptic Children by Tissue Doppler Echocardiography

Abstract

The antiepileptic Valproic acid (VPA) changes the oxidative/ anti-oxidative balance that results in oxidative stress and maybe an increased risk of cardiac dysfunction. The aim of this study was to investigate the effect of VPA on ventricular function in epileptic children. We designed a study to evaluate ventricular function in epileptic children who had received VPA for at least one year. All subjects were evaluated using standard echocardiography, pulsed wave Doppler (PWD), and tissue Doppler imaging (TDI). This study consisted of 60 patients with epilepsy (mean age 10.30±3.21 years) and 60 healthy subjects in the control group (mean age 10.28±3.18 years). The duration of antiepilepsy medication ranged from 1.4 to 10 years, and the dose of VPA was 5-30 mg/kg. The ejection fraction and fractional shortening (P=0.841 and 0.064, respectively) were not significantly different between the two groups. The present study reports subclinical right and left ventricular systolic and diastolic dysfunction along with longitudinal ventricular motion disorder. It is recommended the evaluation of subclinical cardiac dysfunction in children treated by VPA.

 

1. Arhan E, Ayçiçek S, Akaln N, Güven A, Köse G. Cardiac effects of carbamazepine treatment in childhood epilepsy. The neurologist. 2009;15(5):268-73.
2. Saetre E, Abdelnoor M, Amlie JP, Tossebro M, Perucca E, Tauboll E, et al. Cardiac function and antiepileptic drug treatment in the elderly: a comparison between lamotrigine and sustained-release carbamazepine. Epilepsia. 2009;50(8):1841-9.
3. Jansen K, Lagae L. Cardiac changes in epilepsy. Seizure. 2010;19(8):455-60.
4. Kwon S, Lee S, Hyun M, Choe B-H, Kim Y, Park W, et al. The potential for QT prolongation by antiepileptic drugs in children. Pediatric neurology. 2004;30(2):99-101.
5. Cramer JA, Mintzer S, Wheless J, Mattson RH. Adverse effects of antiepileptic drugs: a brief overview of important issues. Expert review of neurotherapeutics. 2010;10(6):885-91.
6. Cengiz M, Yüksel A, Seven M. The effects of carbamazepine and valproic acid on the erythrocyte glutathione, glutathione peroxidase, superoxide dismutase and serum lipid peroxidation in epileptic children. Pharmacological research. 2000;41(4):423-5.
7. Raza M, Al-Bekairi AM, Ageel AM, Qureshi S. Biochemical basis of sodium valproate hepatotoxicity and renal tubular disorder: time dependence of peroxidative injury. Pharmacol Res. 1997;35(2):153-7.
8. Verrotti A, Scardapane A, Franzoni E, Manco R, Chiarelli F. Increased oxidative stress in epileptic children treated with valproic acid. Epilepsy research. 2008;78(2-3):171-7.
9. Emekli-Alturfan E, Alev B, Tunali S, Oktay S, Tunali-Akbay T, Ozturk LK, et al. Effects of edaravone on cardiac damage in valproic acid induced toxicity. Annals of Clinical & Laboratory Science. 2015;45(2):166-72.
10. Arhan E, Serdaroglu A, Ozturk B, Ozturk HS, Ozcelik A, Kurt N, et al. Effects of epilepsy and antiepileptic drugs on nitric oxide, lipid peroxidation and xanthine oxidase system in children with idiopathic epilepsy. Seizure. 2011;20(2):138-42.
11. Bilgi M, Yerdelen D, Çölkesen Y, Müderrisoğlu H. Evaluation of left ventricular diastolic function by tissue Doppler imaging in patients with newly diagnosed and untreated primary generalized epilepsy. Seizure. 2013;22(7):537-41.
12. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 2005;18(12):1440-63.
13. Wadzinski J, Franks R, Roane D, Bayard M. Valproate-associated hyperammonemic encephalopathy. Journal of the American Board of Family Medicine : JABFM. 2007;20(5):499-502.
14. Daniels T, Gallagher M, Tremblay G, Rodgers RL. Effects of valproic acid on cardiac metabolism. Canadian journal of physiology and pharmacology. 2004;82(10):927-33.
15. Mintzer S, Skidmore CT, Abidin CJ, Morales MC, Chervoneva I, Capuzzi DM, et al. Effects of antiepileptic drugs on lipids, homocysteine, and C‐reactive protein. Annals of neurology. 2009;65(4):448-56.
16. Aydin K, Serdaroglu A, Okuyaz C, Bideci A, Gucuyener K. Serum insulin, leptin, and neuropeptide y levels in epileptic children treated with valproate. Journal of child neurology. 2005;20(10):848-51.
17. Kibar AE, Unver O, Oflaz MB, Güven AS, Balli S, Ece İ, et al. Effect of antiepilepsy drug therapy on ventricular function in children with epilepsy: a tissue Doppler imaging study. Pediatric cardiology. 2014;35(2):280-8.
Files
IssueVol 58, No 10 (2020) QRcode
SectionArticles
DOI https://doi.org/10.18502/acta.v58i10.4908
Keywords
Antiepilepsy drugs Epilepsy Tissue doppler imaging Sodium valproate Ventricular dysfunction
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Kamani A, Omidi H, Dorreh F, Shariatmadari F, Ghandi Y. Effect of Sodium Valproate on Cardiac Function in Epileptic Children by Tissue Doppler Echocardiography. Acta Med Iran. 2020;58(10):472-478.