TY - JOUR
T1 - Deceleration capacity derived from a five-minute electrocardiogram predicts mortality in the general population
AU - Steger, Alexander
AU - Barthel, Petra
AU - Müller, Alexander
AU - Rückert-Eheberg, Ina Maria
AU - Linkohr, Birgit
AU - Allescher, Julia
AU - Maier, Melanie
AU - Hapfelmeier, Alexander
AU - Martens, Eimo
AU - Heidegger, Helene Hildegard
AU - Müller, Arne Michael
AU - Rizas, Konstantinos D.
AU - Kääb, Stefan
AU - Sinner, Moritz F.
AU - Sinnecker, Daniel
AU - Laugwitz, Karl Ludwig
AU - Peters, Annette
AU - Schmidt, Georg
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - In contemporary healthcare, effective risk stratification in the general population is vital amidst rising chronic disease rates and an ageing demographic. Deceleration Capacity of the heart rate (DC), derived from 24-hour Holter electrocardiograms, holds promise in risk stratification for cardiac patients. However, the potential of short-term electrocardiograms of five minutes duration for population screening has not been fully explored. Our study aims to investigate the utility of Deceleration Capacity derived from short-term electrocardiograms as a scalable, fully-automated screening tool for predicting long-term mortality risk in the general population. Within a cohort of a representative population-based survey in Germany (KORA-KMC-study), 823 participants with sinus rhythm aged 27 to 76 years at enrollment (females 47.4%) were followed for a median of 13.4 years (IQR 13.1–13.6). All-cause mortality was defined as the primary endpoint and observed in 159 participants. Deceleration Capacity was calculated from 5-minute 12-lead electrocardiograms by a fully automated approach. Participants were divided into three predefined risk categories: DCcategory0 – low-risk (> 4.5ms); DCcategory1 – intermediate-risk (2.5-4.5ms); and DCcategory2 – high-risk (≤ 2.5ms). More than two-thirds of the participants (n = 564, 68.5%) fell into DCcategory0, about one-fifth (n = 168, 20.4%) into DCcategory1, and about one-tenth (n = 91, 11.1%) into DCcategory2. Estimated 13-years mortality in the risk groups was 16.7%, 23.5%, and 49.1%, respectively (p < 0.001). Adjusting for age, life-style-related risk factors, and comorbidities, increased mortality risk was observed for DCcategory2 (HR 2.34, 95%-CI 1.56–3.50). Deceleration Capacity, derived automatically from brief 5-minute electrocardiogram recordings, emerges as a robust, feasible, and independent predictor of long-term mortality risk in the general population.
AB - In contemporary healthcare, effective risk stratification in the general population is vital amidst rising chronic disease rates and an ageing demographic. Deceleration Capacity of the heart rate (DC), derived from 24-hour Holter electrocardiograms, holds promise in risk stratification for cardiac patients. However, the potential of short-term electrocardiograms of five minutes duration for population screening has not been fully explored. Our study aims to investigate the utility of Deceleration Capacity derived from short-term electrocardiograms as a scalable, fully-automated screening tool for predicting long-term mortality risk in the general population. Within a cohort of a representative population-based survey in Germany (KORA-KMC-study), 823 participants with sinus rhythm aged 27 to 76 years at enrollment (females 47.4%) were followed for a median of 13.4 years (IQR 13.1–13.6). All-cause mortality was defined as the primary endpoint and observed in 159 participants. Deceleration Capacity was calculated from 5-minute 12-lead electrocardiograms by a fully automated approach. Participants were divided into three predefined risk categories: DCcategory0 – low-risk (> 4.5ms); DCcategory1 – intermediate-risk (2.5-4.5ms); and DCcategory2 – high-risk (≤ 2.5ms). More than two-thirds of the participants (n = 564, 68.5%) fell into DCcategory0, about one-fifth (n = 168, 20.4%) into DCcategory1, and about one-tenth (n = 91, 11.1%) into DCcategory2. Estimated 13-years mortality in the risk groups was 16.7%, 23.5%, and 49.1%, respectively (p < 0.001). Adjusting for age, life-style-related risk factors, and comorbidities, increased mortality risk was observed for DCcategory2 (HR 2.34, 95%-CI 1.56–3.50). Deceleration Capacity, derived automatically from brief 5-minute electrocardiogram recordings, emerges as a robust, feasible, and independent predictor of long-term mortality risk in the general population.
KW - Autonomic regulation
KW - Deceleration capacity of the heart rate
KW - Electrocardiogram
KW - Fully automated biosignal analysis
KW - General population screening
KW - Non-invasive long-term risk stratification
UR - http://www.scopus.com/inward/record.url?scp=85212776409&partnerID=8YFLogxK
U2 - 10.1038/s41598-024-83712-w
DO - 10.1038/s41598-024-83712-w
M3 - Article
AN - SCOPUS:85212776409
SN - 2045-2322
VL - 14
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 30566
ER -