Cardiac effects of carbamazepine treatment in childhood epilepsy.
OBJECTIVE
Hypotension, bradycardia, and atrioventricular block are well-known cardiovascular effects of carbamazepine (CBZ). However, direct effects of CBZ on ventricular functions have been rarely encountered. We investigated the effect of CBZ on ventricular functions in pediatric patients without previous cardiac disease to determine whether CBZ causes ventricular dysfunction or electrocardiographic changes in therapeutic doses in children.


METHODS
The study includes 40 patients (31 boys, 9 girls) with epilepsy who had been treated with carbamazepine. Electroencephalography, electrocardiography, echocardiography, and cranial imaging were performed on all patients before treatment and were repeated at the end of the third and 12th months of treatment. The systolic and diastolic thickness of the interventricular septum and the posterior wall of the left ventricle and the systolic and diastolic diameter of the left ventricle were measured during M-mode investigation. The end-systolic and end-diastolic volumes (mL), the stroke volume (mL), fractional shortening (FS), (%) and ejection fraction (EF) (%) measurements were obtained from the computer on the echocardiography device.


RESULTS
In 1-year follow-up, no electrocardiographic abnormalities were detected. The FS and EF values showing left ventricular function did not show a significant difference (P > 0.05).


CONCLUSIONS
CBZ seems to be a safe drug in pediatric epileptic patients without any preexisting cardiac disease. We suggest that the risk factors should be defined and followed-up regarding cardiac function when treatment is initiated in groups with risk factors.
Arhan
Ebru
E
Department of Pediatrics, Ankara Dişkapi Children's Hospital, Ankara, Turkey. petekarhan@yahoo.com.tr
Ayçiçek
Semsettin
S
Akaln
Nursel
N
Güven
Alev
A
Köse
Gülşen
G
D000293:Adolescent; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D002220:Carbamazepine / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004562:Electrocardiography; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000188:drug therapy / Q000473:pathology; D004827:Epilepsy / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006346:Heart Septum / Q000187:drug effects / Q000473:pathology; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008297:Male
D000927:Anticonvulsants; D002220:Carbamazepine