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Deceleration capacity: A novel predictor for total mortality in patients with non-ischemic dilated cardiomyopathy

Thomas Demming1, Sarah Sandrock1, Christian Kuhn1

  • 1Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.

International Journal of Cardiology
|July 13, 2016
PubMed

Insights

Deceleration capacity (DC) effectively predicts mortality in non-ischemic dilated cardiomyopathy (NICM) patients. Impaired DC indicates a higher risk, offering a new tool for patient risk stratification.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function
  • Cardiac Electrophysiology

Background:

  • Non-ischemic dilated cardiomyopathy (NICM) carries a high risk of sudden cardiac death (SCD).
  • Current risk stratification for NICM relies heavily on LVEF, with limited options beyond this metric.
  • Deceleration capacity (DC) has previously demonstrated predictive value for mortality in post-myocardial infarction patients.

Purpose of the Study:

  • To investigate if deceleration capacity (DC) is an independent predictor of mortality in patients with NICM.
  • To assess the utility of DC as a novel marker for cardiac autonomic modulation in this patient population.

Main Methods:

  • Analysis of Holter-ECG recordings from 201 NICM patients (mean age 61.4 years, mean LVEF 33.3%).
  • Utilized the phase-rectified-signal-averaging (PRSA) method to calculate DC.
  • Kaplan-Meier analysis was performed for survival assessment.

Main Results:

  • A total of 59 deaths occurred during a minimum 40-month follow-up period.
  • Patients with DC below 4.5 ms exhibited significantly higher mortality rates (log rank p=0.012).
  • This association remained significant regardless of atrial fibrillation presence.

Conclusions:

  • Reduced deceleration capacity (DC) serves as a potent independent predictor of mortality in NICM patients.
  • DC offers a valuable new parameter for risk stratification in non-ischemic dilated cardiomyopathy.
Abstract

Keywords:
Deceleration capacityHeart rate variabilityNon ischemic dilated cardiomyopathy

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