Clinical and electrocardiographic covariates of deceleration capacity in patients with ST-segment elevation
Joanna Lewek1, Jerzy Krzysztof Wranicz, Przemysław Guzik
1Department of Electrocardiology, Sterling Memorial University Hospital, Medical University of Łódź, Poland. asialewek@gmail.com
Insights
Deceleration capacity, a novel ECG measure, is linked to heart rate, age, gender, and hypertension in ST-elevation myocardial infarction patients. Abnormal deceleration capacity is more prevalent in older, hypertensive individuals.
Area of Science:
- Cardiology
- Electrophysiology
- Autonomic Nervous System Function
Background:
- Deceleration capacity (DC) is a novel electrocardiography (ECG) parameter that quantifies the heart's ability to slow down.
- Understanding DC's clinical correlates is crucial for patients experiencing ST-segment elevation myocardial infarction (STEMI).
Purpose of the Study:
- To investigate the clinical and ECG factors associated with deceleration capacity in STEMI patients undergoing primary angioplasty.
- To identify predictors of abnormal DC in this patient cohort.
Main Methods:
- Assessed DC, heart rate variability (HRV), and heart rate turbulence (HRT) from 24-hour ECG Holter recordings in 70 STEMI patients.
- Evaluated DC as both a continuous and dichotomized variable.
Main Results:
- Abnormal DC (< or = 4.5 ms) was observed in 43% of patients and was more common in females, older individuals, and those with hypertension.
- DC correlated significantly with mean heart rate, HRV indices, and HRT slope.
- Hypertension and a mean heart rate > 70 bpm were independent predictors of abnormal DC.
Conclusions:
- Deceleration capacity in STEMI patients is influenced by demographic factors (age, gender) and clinical conditions (hypertension, heart rate).
- Myocardial infarction location and left ventricular ejection fraction did not significantly impact DC.
- The correlation between DC and HRV/HRT suggests DC reflects autonomic modulation of heart rate.
Background:
Deceleration capacity (DC) is a novel electrocardiography (ECG) parameter characterizing the overall capacity of slowing down the heart rate. The aim of this study was to evaluate clinical and ECG covariates of DC in patients with the first episode of ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty.
Methods:
Deceleration capacity, heart rate variability (HRV) and heart rate turbulence (HRT) were assessed from 24-hour ECG Holter recordings in 70 patients (66 male, mean age 57 years) with STEMI. Deceleration capacity was evaluated as continuous or dichotomized (< or = 4.5 vs. > 4.5 ms) variable.
Results:
The median value of DC was 5.12 ms. Thirty patients (43%) had abnormal DC ( < or = 4.5 ms). The abnormal DC was more common in female, older and hypertensive patients. Although DC was not associated with either STEMI localization or left ventricular ejection fraction, it was significantly correlated with mean heart rate, standard HRV indices and HRT slope. Multivariate logistic regression showed that hypertension (OR = 3.23, 95% CI = 1.1-9.9, p = 0.039) and mean heart rate > 70 beats/minute (OR = 6.05, 95% CI = 2.0-18.4, p = 0.001) were independently associated with abnormal DC.
Conclusions:
Deceleration capacity in patients with the first STEMI treated with primary angioplasty is influenced by age, gender, hypertension and heart rate, but not the location of myocardial infarction or left ventricular ejection fraction. Correlation between DC and HRV indices suggests that DC is related to autonomic modulation of heart rate.
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