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Evaluating deceleration and acceleration capacities: Implications for predicting adverse outcomes in patients with

Zhiyao Wei1, Jinghan Huang2, Jie Liu3

  • 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China; State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Heart Rhythm
|September 3, 2025
PubMed

Insights

Deceleration capacity (DC) and acceleration capacity (AC) of heart rate predict mortality in hypertrophic cardiomyopathy (HCM) patients. These autonomic markers identify individuals at high risk for adverse outcomes, aiding clinical management.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function
  • Electrophysiology

Background:

  • Abnormal cardiac autonomic function is common in hypertrophic cardiomyopathy (HCM) but its prognostic implications are unclear.
  • Deceleration capacity (DC) and acceleration capacity (AC) are emerging markers of parasympathetic and sympathetic activity, respectively.
  • Understanding these markers' role in HCM prognosis is crucial for risk stratification.

Purpose of the Study:

  • To investigate whether DC and AC can predict adverse clinical outcomes in patients diagnosed with HCM.
  • To assess the independent predictive value of DC and AC for mortality in this cohort.

Main Methods:

  • A prospective observational cohort study involving 856 unrelated HCM patients.
  • Data collected between 2013 and 2022.
  • Primary outcome: all-cause death; Secondary outcome: cardiovascular death.
  • Cox regression analysis was employed to evaluate associations between variables and outcomes.

Main Results:

  • Over a median follow-up of 3.0 years, 25 all-cause deaths and 17 cardiovascular deaths occurred.
  • Lower DC values were significantly associated with increased risk of all-cause and cardiovascular death (unadjusted HRs > 1.3, P < .05).
  • Adjusted analysis confirmed DC as an independent predictor of all-cause death (aHR = 1.330, P = .010).
  • Higher AC values were linked to increased risk for both endpoints (unadjusted HRs > 1.4, P < .001).
  • The association between AC and all-cause death remained significant after adjustment (aHR = 1.391, P = .002).

Conclusions:

  • Both DC and AC serve as independent predictors of elevated mortality risk in HCM patients.
  • These heart rate variability parameters demonstrate clinical utility as electrophysiological markers.
  • DC and AC can aid in identifying high-risk individuals with HCM for closer monitoring and management.
Abstract

Keywords:
Autonomic nervous systemCardiomyopathyElectrocardiogramElectrophysiologyPrognosis

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