title: Does ketogenic diet have any negative effect on cardiac systolic and diastolic functions in children with intractable epilepsy?: One-year follow-up results.
abstract: OBJECTIVE
  The ketogenic diet (KD) has been referred to as an "effective therapy with side effects" for children with intractable epilepsy. Among the most recognized adverse effects, there are cardiac conduction abnormalities, vascular and myocardial dysfunction. However, very limited and controversial data are available regarding the effects of the KD on cardiac functions. We sought to analyze the mid-term effect of ketogenic diet on cardiac functions in patients with intractable epilepsy who received a ketogenic diet for at least 12months using conventional and relatively new imaging techniques.
  
  
  METHODS
  This prospective study included 61 patients with intractable epilepsy who received ketogenic diet for at least 12months. Clinical examinations, serum carnitine and selenium levels as well as electrocardiographic and echocardiographic examinations were scheduled prior to the procedure and at 1, 3, 6 and 12months. We utilized two-dimensional, M-mode, colored Doppler, spectral Doppler and pulsed wave tissue Doppler imaging techniques to investigate ventricular systolic and diastolic functions of this subgroup of patients.
  
  
  RESULTS
  In our study, there was no significant difference after 1year of KD therapy compared to baseline values-except a significantly decreased A wave velocity-in terms of pulse wave Doppler echocardiographic measurements of the diastolic function. The tissue Doppler measurements obtained from the lateral wall of tricuspide and mitral annuli were not different at baseline and at month 12 of the treatment, as well.
  
  
  CONCLUSIONS
  The ketogenic diet appears to have no disturbing effect on ventricular functions in epileptic children in the midterm.
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Department of Pediatric Cardiology, Izmir, Turkey. Electronic address: rahmiozdemir35@gmail.com.
authors.forename: Rahmi
authors.initials: R
authors.lastname: Ozdemir
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Department of Pediatric Cardiology, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kucuk
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Department of Pediatric Neurology, Izmir, Turkey.
authors.forename: Orkide
authors.initials: O
authors.lastname: Guzel
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Department of Pediatric Cardiology, Izmir, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Karadeniz
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Department of Pediatric Neurology, Izmir, Turkey.
authors.forename: Unsal
authors.initials: U
authors.lastname: Yilmaz
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Department of Pediatric Cardiology, Izmir, Turkey.
authors.forename: Timur
authors.initials: T
authors.lastname: Mese
mesh_terms: D002675:Child, Preschool; D055423:Diet, Ketogenic / Q000009:adverse effects; D000069279:Drug Resistant Epilepsy / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007659:Ketones / Q000097:blood; D008297:Male; D011446:Prospective Studies
chemical_list: D007659:Ketones
keywords: Children; Diastolic function; Epilepsy; Ketogenic diet; Systolic function