Key result
Children with convulsive seizures had significantly higher levels of CK-MB mass (p<0.05) and BNP (p<0.001) 12 hours post-seizure compared to healthy controls, suggesting subtle cardiac dysfunction.
Why the study?
Do convulsive seizures cause myocardial injury or cardiac dysfunction as measured by cardiac biomarkers in children and adolescents?
Case-Control (n=81)
Do convulsive seizures cause myocardial injury or cardiac dysfunction as measured by cardiac biomarkers in children and adolescents?
Elevated BNP and CK-MB mass following convulsive seizures in children suggest subtle cardiac dysfunction, despite normal cTnI levels.
Answers are grounded in this paper and cite their sources.
May indicate subtle postictal cardiac effects in children; hypothesis-generating and should not yet change monitoring practice.
PURPOSE: To evaluate the presence of myocardial injury during convulsive seizures in children and adolescents by determining serum concentrations of cardiac troponin I (cTnI), creatine kinase-MB mass (CK-MB mass), and plasma brain-type natriuretic peptide (BNP). METHODS: Thirty-one children (20 boys; mean age, 6.6 +/- 5.34 years) with convulsive seizures and 50 healthy children were enrolled. Serum cTnI, CK-MB mass, and plasma BNP concentrations were analyzed 12 h after the seizure and repeated 7 days thereafter in the patient group and obtained one time in the control group. RESULTS: The difference between serum concentrations of cTnI obtained 12 h and 7 days after the seizure was not statistically significant. cTnI levels 12 h postictal and those in control subjects also were not significantly different. CK-MB mass and BNP at the 12th h were higher than those obtained on the 7th day (p < 0.05 and p < 0.001, respectively). Children with seizures had increased levels of CK-MB mass and BNP 12 h after seizure than control subjects (p < 0.05 and p < 0.001, respectively). The results of electrocardiography (ECG) recordings, which were obtained up to 30 min after seizure activity, were completely normal in patients with seizure. CONCLUSION: Normal cTnI levels are not indicative of overt myocardial necrosis in patients with seizures. However, markedly elevated BNP concentrations together with elevated CK-MB mass levels do suggest subtle cardiac dysfunction in patients with seizure, and further large-scale studies are warranted.
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Alehan et al. (2008) conducted a case-control in Convulsive seizures (n=81). Convulsive seizures vs. Healthy children was evaluated on Serum concentrations of cTnI, CK-MB mass, and plasma BNP (p=<0.001). Children with convulsive seizures had significantly higher levels of CK-MB mass (p<0.05) and BNP (p<0.001) 12 hours post-seizure compared to healthy controls, suggesting subtle cardiac dysfunction.
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