Johan Denollet1, Romy A van Felius2, Paul Lodder2, Paula M Mommersteeg2, Inge Goovaerts3, Nadine Possemiers3, Luc Vanhees4, Paul Beckers3, Nele Pattyn4, Emeline M Van Craenenbroeck3. 1. CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, The Netherlands; Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium. Electronic address: J.Denollet@tilburguniversity.edu. 2. CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, The Netherlands. 3. Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium. 4. Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Heverlee, Belgium.
Abstract
BACKGROUND: Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD). METHODS: At baseline, 180 CAD patients (90% men; M = 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34+/KDR+/CD45+dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function. RESULTS: Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p = 0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p = 0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD <5.5% cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65%) than non-Type Ds (63/143 = 44%); OR = 3.03, 95% CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR = 3.43, 95% CI 1.01-11.64), and in subgroup analyses of male patients. CONCLUSIONS: Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.
RCT Entities:
BACKGROUND: Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD). METHODS: At baseline, 180 CAD patients (90% men; M = 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34+/KDR+/CD45+dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function. RESULTS: Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p = 0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p = 0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD <5.5% cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65%) than non-Type Ds (63/143 = 44%); OR = 3.03, 95% CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR = 3.43, 95% CI 1.01-11.64), and in subgroup analyses of male patients. CONCLUSIONS: Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.
Authors: Doralisa Morrone; Maria Elena Lucia Picoi; Francesca Felice; Andrea De Martino; Cristian Scatena; Paolo Spontoni; Antonio Giuseppe Naccarato; Rossella Di Stefano; Uberto Bortolotti; Massimo Dal Monte; Stefano Pini; Marianna Abelli; Alberto Balbarini Journal: Int J Mol Sci Date: 2021-11-28 Impact factor: 5.923
Authors: Dirkjan Kauw; Dounya Schoormans; Gertjan Tj Sieswerda; Joost P Van Melle; Hubert W Vliegen; Arie P J Van Dijk; Mariët S Hulsbergen-Zwarts; Marco C Post; Tieneke J Ansink; Barbara J M Mulder; Berto J Bouma; Mark J Schuuring Journal: J Cardiovasc Nurs Date: 2022 Mar-Apr 01 Impact factor: 2.083