Cardiac deceleration capacity and acceleration capacity have diagnostic value in patients with vasovagal syncope regardless of age

Jijing Wang; Jinyi Xu; Yanyan Qiu; Ruike Yang; Wentao Wang; Chuanyu Gao

doi:10.3389/fcvm.2024.1495129

Cardiac deceleration capacity and acceleration capacity have diagnostic value in patients with vasovagal syncope regardless of age

Front Cardiovasc Med. 2024 Dec 18:11:1495129. doi: 10.3389/fcvm.2024.1495129. eCollection 2024.

Authors

Jijing Wang¹, Jinyi Xu¹, Yanyan Qiu¹, Ruike Yang¹, Wentao Wang², Chuanyu Gao^{3

4}

Affiliations

¹ Department of Cardiopulmonary Function, Zhengzhou University People's Hospital (Henan Provincial People's Hospital), Zhengzhou, Henan, China.
² Department of Cardiopulmonary Function, Fuwai Central China Cardiovascular Hospital, Zhengzhou, Henan, China.
³ Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, Henan, China.
⁴ Department of Cardiology, Zhengzhou University People's Hospital (Henan Provincial People's Hospital), Zhengzhou, Henan, China.

Abstract

Background: Deceleration capacity (DC) and acceleration capacity (AC) are used to characterize autonomic regulation. The purpose of this study was to evaluate the autonomic nervous function in patients with vasovagal syncope (VVS) and to evaluate the diagnostic value of DC and AC for VVS.

Methods: A total of 94 consecutive patients with VVS [51.0 (38.0-60.0) years; 48 males] and 76 healthy subjects [53.0 (44.3-62.8) years; 46 males] were recruited as controls. The study compared DC, AC, and heart rate variability (HRV) in 24-h ECG, echocardiogram, and biochemical examinations between the two groups.

Results: DC was significantly higher (9.3 ± 2.1 vs. 7.4 ± 1.4 ms, p < .001) and AC was lower (-9.3 ± 2.1 vs. -7.3 ± 1.3 ms, p < .001) in the syncope group compared to the control group. HRV indicators were higher in the syncope group. In multivariable analyses, DC [odds ratio = 1.746 (95% CI, 1.389-2.195); p < .001], AC [odds ratio = 0.553 (95% CI, 0.435-0.702); p < .001] were independently associated with syncope. Mean HR was associated with syncope only in patients <60 years of age. Receiver operating characteristics (ROC) curves showed areas under curve (AUC) of DC/AC for predicting syncope are 0.755/0.765 with sensitivity of 56.4%/60.6% and specificity of 93.4%/88.2%.

Conclusion: Patients with VVS exhibit higher DC and lower AC. Both DC and AC are independently correlated with syncope. A DC value >9.0 ms and an AC value -9.0 ms could potentially be valuable indicators for monitoring cardiac autonomic nervous dysfunction.

Keywords: acceleration capacity; autonomic nervous function; deceleration capacity; syncope; vasovagal syncope.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National key research and development plan “digital medical equipment research and development” pilot project (2018YFC0114502). The funding was not involved in data processing or analysis and writing the manuscript.