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Abstract：
Background and Objectives: People with epilepsy (PWE) have a 2-3 times higher mortality rate than the general population. Sudden unexpected death in epilepsy (SUDEP) comprises a significant proportion of premature deaths, whereas sudden cardiac death (SCD) is among the leading causes of sudden death in the general population. Cardiac pathologies are significantly more prevalent in PWE. Whether electrocardiographic (ECG) parameters are associated with remote death in PWE has yet to be elucidated. The study objective was to assess whether interictal ECG parameters are associated with mortality in the long-term. Materials and Methods: The study involved 471 epilepsy patients who were hospitalized after a bilateral tonic-clonic seizure(s). ECG parameters were obtained on the day of hospitalization (heart rate, PQ interval, QRS complex, QT interval, heart rate corrected QT interval (QTc), ST segment and T wave changes), as well as reported ECG abnormalities. Mortality data were obtained from the Latvian National Cause-of-Death database 3-11, mean 7.0 years after hospitalization. The association between the ECG parameters and the long-term clinical outcome were examined. Results: At the time of assessment, 75.4% of patients were alive and 24.6% were deceased. Short QTc interval (odds ratio (OR) 4.780; 95% confidence interval (CI) 1.668-13.698; p = 0.004) was associated with a remote death. After the exclusion of known comorbidities with high mortality rates, short QTc (OR 4.631) and ECG signs of left ventricular hypertrophy (OR 5.009) were associated with a remote death. Conclusions: The association between routine 12-lead rest ECG parameters-short QTc interval and a pattern of left ventricular hypertrophy-and remote death in epilepsy patients was found. To the best of our knowledge, this is the first study to associate rest ECG parameters with remote death in an epileptic population.
摘要：
背景和目的：癫痫患者（PWE）的死亡率是普通人群的2-3倍。癫痫突然意外死亡（SUDEP）占过早死亡的很大比例，而心脏猝死（SCD）是一般人群中猝死的主要原因之一。心脏病变在PWE中明显更普遍。尚未阐明心电图（ECG）参数是否与PWE中的远程死亡有关。本研究的目的是评估发作间心电图参数是否与长期死亡率相关。材料和方法：该研究涉及471例癫痫患者，他们在双侧强直阵挛性癫痫发作后住院。在住院当天获得ECG参数（心率，PQ间隔,QRS复合波,QT间期,心率校正QT间期(QTc),ST段和T波变化),以及报告的心电图异常。死亡率数据来自拉脱维亚国家死亡原因数据库3-11，平均住院后7.0年。检查了ECG参数与长期临床结果之间的关联。结果：在评估时，75.4％的患者活着，24.6％的患者死亡。短QTc间期（比值比（OR）4.780;95％置信区间（CI）1.668-13.698;p=0.004）与远程死亡相关。在排除具有高死亡率的已知合并症之后，左心室肥厚的短QTc(OR4.631)和心电图征象(OR5.009)与远程死亡相关.结论：发现癫痫患者常规12导联静息心电图参数-短QTc间期与左心室肥厚和远程死亡模式之间存在关联。据我们所知,这是首次将静息心电图参数与癫痫患者远程死亡相关联的研究.
