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

IF 3.8 2区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Scientific Reports Pub Date : 2024-12-19 DOI:10.1038/s41598-024-83712-w

Alexander Steger, Petra Barthel, Alexander Müller, Ina-Maria Rückert-Eheberg, Birgit Linkohr, Julia Allescher, Melanie Maier, Alexander Hapfelmeier, Eimo Martens, Helene Hildegard Heidegger, Arne Michael Müller, Konstantinos D Rizas, Stefan Kääb, Moritz F Sinner, Daniel Sinnecker, Karl-Ludwig Laugwitz, Annette Peters, Georg Schmidt

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Abstract

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 < 0.001). Adjusting for age, life-style-related risk factors, and comorbidities, increased mortality risk was observed for DC_category2 (HR 2.34, 95%-CI 1.56-3.50). Deceleration Capacity, derived automatically from brief 5-minute electrocardiogram recordings, emerges as a robust, feasible, and independent predictor of long-term mortality risk in the general population.

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从5分钟心电图得出的减速能力可以预测一般人群的死亡率。

在当代医疗保健中，在慢性病发病率上升和人口老龄化的背景下，对普通人群进行有效的风险分层是至关重要的。从24小时动态心电图中得出的心率减速能力（DC）在心脏病患者的风险分层中具有前景。然而，5分钟短期心电图在人群筛查中的潜力尚未得到充分探索。我们的研究旨在调查短期心电图得出的减速能力作为预测普通人群长期死亡风险的可扩展、全自动筛查工具的实用性。在德国一项具有代表性的基于人群的队列调查（KORA-KMC-study）中，823名年龄在27至76岁之间的窦性心律患者（女性47.4%）被随访，中位时间为13.4年（IQR为13.1-13.6）。全因死亡率被定义为主要终点，并在159名参与者中观察到。通过全自动方法从5分钟12导联心电图计算减速能力。参与者被分为三个预定义的风险类别：DCcategory0 -低风险（> 4.5ms）；dccategy1 -中度风险（2.5-4.5ms）；dccategy2 -高风险（≤2.5ms）。超过三分之二（n = 564, 68.5%）的参与者属于DCcategory0，约五分之一（n = 168, 20.4%）的参与者属于DCcategory1，约十分之一（n = 91, 11.1%）的参与者属于DCcategory2。风险组的13年死亡率分别为16.7%、23.5%和49.1% (p分类2 （HR 2.34, 95%-CI 1.56-3.50）。从简短的5分钟心电图记录中自动得出的减速能力，成为普通人群长期死亡风险的可靠、可行和独立的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scientific Reports Natural Science Disciplines-

CiteScore

7.50

自引率

4.30%

发文量

19567

审稿时长

3.9 months

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