Key result
24-hour heart rate deceleration capacity shows strong 3-year stability with ~62% heritability.
Cohort (n=1,291)
No
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Twenty-four-hour heart rate deceleration capacity is a highly heritable (62%) and temporally stable biological trait over 3 years, whereas 5-minute recordings suffer from substantial circadian variation and measurement error, indicating that clinical risk stratification models using DC should standardize recording timing and adjust for age and sex.
Purpose Deceleration capacity is becoming a more widely used predictor for health outcomes and cardiac autonomic dysfunction, but its measurement characteristics and biological determinants remain insufficiently understood. This study examined these factors in a large population-based sample (n = 1291) from the Netherlands Twin Register. Methods Participants wore an physiological monitoring device for 24 hours, and deceleration capacity was computed through phase-rectified signal averaging. To test whether short recordings might suffice, deceleration capacity estimates derived from 5-minute segments were compared with estimates obtained from full 24-hour ambulatory recordings. Temporal stability was examined in a subsample of participants measured again roughly three years later, and twin modeling was used to determine how much of the individual variance was explained by environmental and genetic factors. Results The results indicated that short-term deceleration capacity derived from 5-minute segments can deviate substantially from those derived from the full 24-hour recording, and that these deviations vary systematically across the day. It showed moderate to strong temporal stability across two measurement occasions roughly three years apart (r = .74, ICC(A,1) = .74). In addition, deceleration capacity was negatively associated with age (β = -0.04, R² = .14) and BMI (β = -0.04, R² = .03), and was higher in males than females (M = 4.70 vs M = 4.12). We further found substantial heritability of deceleration capacity (h 2 = .62). Conclusions Together, these findings establish that 24-hour DC reflects a stable biological trait, which is in line with its prognostic potential for health outcomes.
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Ven et al. (2026) conducted a cohort in Healthy twins and siblings screened to be free of cardiovascular or autonomic disease (n=1,291). 24-hour ambulatory ECG recording and 5-minute segment heart rate deceleration capacity (DC) assessment vs. Full 24-hour ambulatory DC recording vs 5-minute DC segments, repeated measurement at ~3.2 years, and twin/sibling zygosity comparisons was evaluated on Temporal stability (intraclass correlation coefficient ICC(A,1)) and heritability (h²) of 24-hour heart rate deceleration capacity (ICC(A,1) = 0.74; h² = 0.62, 95% CI 0.60-0.84, p=<0.001). 24-hour heart rate deceleration capacity showed strong 3-year temporal stability and 62% heritability, while 5-minute estimates deviated across the day.
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