title: Deceleration capacity: A novel predictor for total mortality in patients with non-ischemic dilated cardiomyopathy.
abstract: OBJECTIVE
  We hypothesized that deceleration capacity (DC), a novel marker of cardiac autonomic modulation, is an independent predictor for mortality in patients with non-ischemic dilated cardiomyopathy (NICM).
  
  
  BACKGROUND
  NICM is associated with a high risk for sudden cardiac death (SCD). However there are no clinically established parameters available for risk stratification beyond LVEF. DC has been previously shown to be a strong independent predictor for total mortality in patients after myocardial infarction.
  
  
  METHODS
  Holter-ECG recordings of 201 patients NICM (83.1% male, mean age: 61.4years, mean LVEF: 33.3%) were analyzed by the method of phase-rectified-signal-averaging (PRSA) to obtain DC.
  
  
  RESULTS
  During a minimum follow-up of 40month 59 patients died. Kaplan Meyer Analysis showed a significantly higher mortality in patients with a DC below 4.5ms (log rank p=0.012) irrespective to the presence of atrial fibrillation.
  
  
  CONCLUSIONS
  Impaired DC is a powerful independent predictor for mortality in patients with NICM.
authors.affiliation: Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Demming
authors.affiliation: Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sandrock
authors.affiliation: Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kuhn
authors.affiliation: Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Kotzott
authors.affiliation: Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.
authors.forename: Nihat
authors.initials: N
authors.lastname: Tahmaz
authors.affiliation: Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany. Electronic address: hendrik.bonnemeier@uk-sh.de.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bonnemeier
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D003654:Deceleration; D015716:Electrocardiography, Ambulatory / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011237:Predictive Value of Tests; D013318:Stroke Volume / Q000502:physiology
keywords: Deceleration capacity; Heart rate variability; Non ischemic dilated cardiomyopathy