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

Area of Science:

• Cardiology
• Preventive Medicine
• Biostatistics

Background:

• Rising chronic disease rates and an aging population necessitate effective risk stratification in general healthcare.
• Deceleration Capacity (DC), typically derived from 24-hour Holter ECGs, shows promise for cardiac patient risk assessment.
• The utility of short-term ECGs for population-wide screening of DC remains underexplored.

Purpose of the Study:

• To investigate the effectiveness of Deceleration Capacity (DC) derived from short-term (5-minute) ECGs as a scalable, automated tool.
• To assess the predictive value of DC from brief ECGs for long-term mortality risk in the general population.

Main Methods:

• Utilized a representative German population-based cohort (KORA-KMC-study) with 823 participants in sinus rhythm.
• Calculated Deceleration Capacity (DC) from automated 5-minute 12-lead ECG recordings.
• Followed participants for a median of 13.4 years, monitoring all-cause mortality.

Main Results:

• Participants were categorized into low (DC > 4.5ms), intermediate (2.5-4.5ms), and high (≤ 2.5ms) risk groups.
• Estimated 13-year mortality rates were 16.7% (low), 23.5% (intermediate), and 49.1% (high) (p < 0.001).
• High-risk DC category (DC ≤ 2.5ms) independently predicted increased mortality (HR 2.34) after adjusting for confounders.

Conclusions:

• Deceleration Capacity derived from brief, automated 5-minute ECGs is a robust predictor of long-term mortality.
• This method offers a feasible and scalable approach for population screening and risk stratification.
• Automated DC analysis from short ECGs can aid in identifying individuals at higher risk for all-cause mortality.