权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Assessing determinants of electrocardiographic alterations and identifying exacerbating factors in pediatric epilepsy

评估心电图改变的决定因素并确定小儿癫痫的恶化因素

基本信息

批准号：
10302120
负责人：
Yi-Chen Lai
金额：
$ 36.96万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10302120
关键词：
Acute Adult Appearance Arrhythmia Blood gas Cardiac Cerebrum Cessation of life Child Childhood Chronic Clinical Data Electrolytes Enrollment Epilepsy Frequencies Future Health Heart Heart Abnormalities Heart Arrest Heart Diseases Heart Rate Hospitalization Hypoxemia Incidence Individual Ions Laboratories Lead Longitudinal Studies Measurement Mechanical ventilation Medical Medicine Modeling Monitor Morphology Outcome Oxygen Pathology Patients Pediatric Hospitals Pediatric cohort Pharmaceutical Preparations Play Population Study Process Prospective Studies Relative Risks Reporting Risk Risk Factors Role Seizures Stress Surrogate Markers Temperature Texas Time Ventricular Remodeling base biomedical referral center childhood epilepsy clinical practice comorbidity demographics follow-up high risk insight modifiable risk mortality mortality risk physiologic stressor premature primary outcome prospective respiratory risk prediction secondary outcome sudden unexpected death in epilepsy supplemental oxygen

项目摘要

PROJECT SUMMARY Sudden unexpected death in epilepsy (SUDEP) is a significant cause of premature death in childhood-onset epilepsy. Aberrant cerebral, respiratory and cardiac processes are candidate mechanisms underlying SUDEP. In support of cardiac mechanism are the findings of higher risk of sudden cardiac arrest in adults with epilepsy, and inter-ictal and peri-ictal electrocardiographic (ECG) abnormalities suggesting increased cardiac vulnerability that results from myocardial remodeling. The appearance of high-risk arrhythmias with peri-ictal hypoxemia suggests that respiratory derangements can also contribute to the cardiac abnormalities in epilepsy. A longitudinal, population-based study of childhood-onset epilepsy has shown that the cumulative SUDEP risk increases with increasing epilepsy duration, suggesting that there might be progressive changes that contribute to mortality risk in adulthood. Our overarching hypothesis is that cardiac electrical remodeling occurs as function of epilepsy duration and renders the heart vulnerable to stresses such as seizures or respiratory derangements over time, thereby contributing to SUDEP. For this proposal we will prospectively follow a cohort of pediatric epilepsy patients without a known ion channelopathy or cardiac disease, who are managed in a quaternary epilepsy referral center using ECG studies as a surrogate marker. We will obtain yearly ECG studies and collect clinical and laboratory data associated with each ECG. For children enrolled in the study who are hospitalized for a respiratory illness during the study period, we will obtain additional ECGs and collect additional clinical information relating to the hospitalizations. Using multivariable models controlling for potential confounders such as seizure semiology and frequency, number of anti-seizure medications, and other factors identified through univariate analyses, we will investigate whether epilepsy duration is an independent risk factor for abnormal ECG. Using an analogous approach, we will also evaluate whether an intercurrent respiratory illness is an independent risk factor for abnormal ECG, and whether epilepsy duration modifies the likelihood of having an abnormal ECG during an intercurrent respiratory illness.

项目总结