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(Abst. 3.328), 2014

Authors: Onder Dokgoz, kubra celegen, Orkide Guzel, U. Yilmaz, Rana Isgüder, mehmet celegen and Timur Mese
Content: Rationale: The aim of the study is to investigate the effects of ketogenic diet on cardiac function assessed with echocardiography in short term period in patients with refractory epilepsy treated with the ketogenic diet. Methods: A total of 38 drug resistant epileptic patients who were treated with ketogenic diet at the pediatric neurology clinic from September 2012 to March 2014 were enrolled in this prospective study. Patients older than 1 year of age with intractable epilepsy who received ketogenic diet for at least sixth months were included into the study. Patients with carnitine or selenium deficiency, dilated cardiomyopathy, ventricular failure, congenital heart disease, left ventricular hypertrophy, systemic hypertension, systemic or metabolic diseases affecting cardiac and vascular functions such as diabetes mellitus, obesity were excluded from the study. Complete transthoracic echocardiography with tissue Doppler imaging (TDI) for the current analysis was performed in all patients before the beginning of ketogenic diet and after the sixth month of therapy. Results: The body weight, height, and body mass index increased significantly at month 6 when compared to baseline values.Variables assessed by conventional echocardiography showed no significant difference at the standpoints of study (p> 0.05).As to Doppler flow indices of mitral annulus velocity of patients at 0.and 6. months showed no significant differences found in E, A and DT values. Mitral E / A ratio changes also were not significant (p> 0.05). With regard to tricuspid annulus velocites, E wave velocity decreased at sixth month, but this wasalso not significant (p> 0.05). Other tricuspid annulus wave velocity changes were not statistically significant too (p> 0.05). Tricuspid annular E / A ratio was found to be statistically significant decrease (p <0.05).TDI studies of mitral annulus including Sa, Ea, Aa velocities, Ea / Aa and E / Ea ratio, IVCT, IVRT, MPI and ET were also not significant (p>0.05). There were no significant changes in Sa, Aa wave velocities, IVCT, IVRT, MPI, ET ve E/Ea ratio gathered from tricuspid annulus TDI study(p>0.05), but Eavelocity and Ea / Aa values were found to be statistically lower after six month (p <0.05). Conclusions: In conventional echocardiographic measurements, although reduction ofE wave velocity is not statistically significant, significant decrease in E/A ratio, and in TDImeasurements significant decrease in Ea wave velocity and Ea/Aa ratio appear as the initial clues of early right ventricular diastolic dysfunction in patients treated withketogenic diet. We believe these data's must be supported with larger scale studies, which have longer duration, and more sophisticated advanced techniques required to reflect diastolic dysfunction obviously.