{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:43:31Z","timestamp":1793371411228,"version":"4.5.0"},"reference-count":60,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Epilepsy is associated with an increased risk of cardiovascular disease and mortality. Whether cardiac structure and function are altered in epilepsy remains unclear. To address this, we conducted a systematic review and meta\u2010analysis of studies evaluating cardiac structure and function in patients with epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched the electronic databases MEDLINE, PubMed, COCHRANE, and Web of Science from inception to 31 December 2021. Primary outcomes of interest included left ventricular ejection fraction (LVEF) for studies reporting echocardiogram findings and cardiac weight and fibrosis for postmortem investigations. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) assessment tools.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 10 case\u2010control studies with epilepsy patients (n\u00a0=\u00a0515) and healthy controls (n\u00a0=\u00a0445), LVEF was significantly decreased in epilepsy group compared with controls (MD: \u22121.80; 95% confidence interval [CI]: \u22123.56 to \u22120.04; <jats:italic>P<\/jats:italic>\u00a0=\u20090.045), whereas A\u2010wave velocity (MD: 4.73; 95% CI: 1.87\u20107.60; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), E\/e' ratio (MD: 0.39; 95% CI: 0.06\u20100.71; <jats:italic>P<\/jats:italic>\u00a0=\u20090.019), and isovolumic relaxation time (MD: 10.18; 95% CI: 2.05\u201018.32; <jats:italic>P<\/jats:italic>\u00a0=\u20090.014) were increased in epilepsy, compared with controls. A pooled analysis was performed in sudden unexpected death in epilepsy (SUDEP) cases with autopsy data (n\u00a0=\u00a0714). Among SUDEP cases, the prevalence of cardiac hypertrophy was 16% (95% CI: 9%\u201323%); cardiac fibrosis was 20% (95% CI: 15%\u201326%). We found no marked differences in cardiac hypertrophy, heart weight, or cardiac fibrosis between SUDEP cases and epilepsy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Our findings suggest that epilepsy is associated with altered diastolic and systolic echocardiogram parameters compared with healthy controls. Notably, SUDEP does not appear to be associated with a higher incidence of structural cardiac abnormalities, compared with non\u2010SUDEP epilepsy controls. Longitudinal studies are needed to understand the prognostic significance of such changes. Echocardiography may be a useful noninvasive diagnostic test in epilepsy population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12692","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T14:50:23Z","timestamp":1673967023000},"page":"46-59","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Cardiac structural and functional abnormalities in epilepsy: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5581-9270","authenticated-orcid":false,"given":"Zining","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Central Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peravina","family":"Thergarajan","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School 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