{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T17:20:44Z","timestamp":1778952044211,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,10]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Patients with epilepsy (PWE) are at increased risk for cardiac abnormalities, including arrhythmias, structural changes, and sudden unexpected death in epilepsy (SUDEP). Although previous studies have examined ventricular dysfunction, left atrial (LA) structural and mechanical changes remain underexplored. This study aimed to evaluate LA remodeling in PWE using echocardiographic markers\u2014LA volume index (LAVI), LA emptying fraction (LAEF), and E\/e' ratio\u2014as well as to examine their associations with SUDEP\u20107 scores.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This prospective, cross\u2010sectional study included 58 PWE and 49 healthy controls. Participants underwent transthoracic echocardiography at least 24\u2009h after a seizure. LAEF and LAVI were calculated using the biplane area\u2013length method. PWE were further stratified into two groups: medically controlled epilepsy (MCE) and drug\u2010resistant epilepsy (DRE). The risk of SUDEP was assessed using the SUDEP\u20107 inventory.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n PWE exhibited significantly higher maximum LAVI (\n p<\/jats:italic>\n \u2009=\u2009.047), lower total LAEF (\n p<\/jats:italic>\n \u2009=\u2009.001), and reduced LA active emptying fraction (\n p<\/jats:italic>\n \u2009=\u2009.001), alongside increased LA passive emptying fraction (\n p<\/jats:italic>\n \u2009=\u2009.028) when compared to the control group. However, no significant differences were noted in the E\/e' ratio. Furthermore, maximum LAVI demonstrated a positive correlation with SUDEP\u20107 scores (\n r<\/jats:italic>\n \u2009=\u2009.265,\n p<\/jats:italic>\n \u2009=\u2009.044). Patients with DRE exhibited significantly higher SUDEP\u20107 scores and longer disease duration in comparison to MCE.\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n This study reveals that reduced LAEF and elevated LAVI may serve as early, underrecognized markers of LA remodeling in chronic epilepsy\u2014changes that are not captured by conventional diastolic indices such as the E\/e' ratio. Given their strong association with SUDEP\u20107 scores, LAEF and LAVI show promise as novel echocardiographic biomarkers for identifying individuals at high risk for cardiovascular events and SUDEP.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/epi.18577","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T14:18:39Z","timestamp":1753280319000},"page":"3964-3971","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Left atrial remodeling in epilepsy: A comparative echocardiographic study of left atrial emptying fraction and left atrial volumetric index in patients with epilepsy"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7553-2034","authenticated-orcid":false,"given":"Selcen","family":"Duran","sequence":"first","affiliation":[{"name":"Department of Neurology Kirsehir Ahi Evran University Faculty of Medicine Kirsehir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6327-8849","authenticated-orcid":false,"given":"Yalcin","family":"Boduroglu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kirsehir Ahi Evran University Faculty of Medicine Kirsehir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.106946"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2024.100696"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12692"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11080241"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.70088"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.059"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554\u2010021\u201002357\u20102"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2013.03.015"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2018.01.016"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2009.02397.x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2010.06.011"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.005"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14697"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.08.017"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14698"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.09.061"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000004292"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000005740"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.18577","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/epi.18577","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.18577","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:24:15Z","timestamp":1772983455000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.18577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/epi.18577"],"URL":"https:\/\/doi.org\/10.1111\/epi.18577","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,23]]},"assertion":[{"value":"2025-04-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}