title: Heart rate variability regression and risk of sudden unexpected death in epilepsy.
abstract: The exact mechanisms of sudden unexpected death in epilepsy remain elusive, despite there is consensus that SUDEP is associated with severe derangements in the autonomic control to vital functions as breathing and heart rate regulation. Heart rate variability (HRV) has been advocated as biomarker of autonomic control to the heart. Cardiac dysautonomia has been found in diseases where other branches of the autonomous nervous system are damaged, as Parkinson disease and multiple system atrophy. In this perspective, an impaired HRV not only is a risk factor for sudden cardiac death mediated by arrhythmias, but also a potential biomarker for monitoring a progressive decline of the autonomous nervous system. This slope may lead to an acute imbalance of the regulatory pathways of vital functions after seizure and then to SUDEP.
authors.affiliation: Cardiovascular Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy. Electronic address: aleg170389@gmail.com.
authors.forename: Alessio
authors.initials: A
authors.lastname: Galli
authors.affiliation: Cardiovascular Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Lombardi
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000401:mortality*; D001341:Autonomic Nervous System / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac; D018450:Disease Progression; D004827:Epilepsy / Q000150:complications* / Q000401:mortality*; D005260:Female; D006321:Heart / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D012372:ROC Curve; D012044:Regression Analysis
chemical_list: D015415:Biomarkers
keywords: Heart rate variability; Holter monitoring; SUDEP