Deceleration capacity derived from a five-minute electrocardiogram predicts mortality in the general population

• Published in: Scientific reports 2024-12, Vol.14 (1), p.30566-8
• Main Authors: Steger, Alexander, Barthel, Petra, Müller, Alexander, Rückert-Eheberg, Ina-Maria, Linkohr, Birgit, Allescher, Julia, Maier, Melanie, Hapfelmeier, Alexander, Martens, Eimo, Heidegger, Helene Hildegard, Müller, Arne Michael, Rizas, Konstantinos D., Kääb, Stefan, Sinner, Moritz F., Sinnecker, Daniel, Laugwitz, Karl-Ludwig, Peters, Annette, Schmidt, Georg
• Format: Article
• Language: English
• Subjects: 631/114; 639/705/1046; 692/308/409; 692/4019; 692/53/2423; 692/700/1750; 692/700/478/2772; Adult; Aged; Aging; Automation; Autonomic regulation; Comorbidity; Deceleration; Deceleration capacity of the heart rate; EKG; Electrocardiogram; Electrocardiography; Electrocardiography - methods; Electrocardiography, Ambulatory - methods; Female; Fully automated biosignal analysis; General population screening; Germany - epidemiology; Health risks; Heart diseases; Heart rate; Heart Rate - physiology; Humanities and Social Sciences; Humans; Male; Middle Aged; Mortality; Mortality risk; multidisciplinary; Non-invasive long-term risk stratification; Population; Population studies; Risk Assessment - methods; Risk Factors; Risk groups; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-83712-w

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: DC category0 – low-risk (> 4.5ms); DC category1 – intermediate-risk (2.5-4.5ms); and DC category2 – high-risk (≤ 2.5ms). More than two-thirds of the participants ( n  = 564, 68.5%) fell into DC category0 , about one-fifth ( n  = 168, 20.4%) into DC category1 , and about one-tenth ( n  = 91, 11.1%) into DC category2 . Estimated 13-years mortality in the risk groups was 16.7%, 23.5%, and 49.1%, respectively ( p