Cited by 140Cardiac Health and Mental HealthCardiac Fibrosis and RemodelingHeart Failure Treatment and Management

Cytokines and immune activation in systolic heart failure: the role of Type D personality

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Denollet, Johan, Conraads, Viviane M, Brutsaert, Dirk L, De Clerck, Luc S, Stevens, Wim J, Vrints, Christiaan J·2003·Brain, Behavior, and Immunity

Abstract

The proinflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) and its soluble receptors 1 (sTNFR1) and 2 (sTNFR2) are predictors of mortality in chronic heart failure (CHF) but the determinants of these increased levels of disease-promoting cytokines are largely unknown. Type D personality refers to the combination of the tendency to experience negative emotions (negative affectivity) and the tendency to inhibit the expression of emotions in social interaction (social inhibition). Type D is an independent predictor of cardiac events in coronary patients who are at risk for CHF. The present study examined the effect of Type D personality on TNF-alpha, sTNFR1, and sTNFR2 in 42 men with CHF (meanage=57.9+/-10.5 years). There was a significant multivariate effect of Type D on TNF-alpha measures (p=.006); i.e., circulating levels of TNF-alpha (4.8+/-0.9 versus 2.5+/-0.2 pg/ml, p=.003), sTNFR1 (1814+/-314 versus 1134+/-78 pg/ml, p=.014), and sTNFR2 (2465+/-243 versus 1874+/-118 pg/ml, p=.019) were significantly higher in Type D patients as compared to non-Type D patients. The effect size (ES) of Type D personality ranged from rather large (sTNFR1, ES=0.77; sTNFR2, ES= 0.73) to large (TNF-alpha, ES=0.90). After controlling for ischemic etiology and severity of heart failure, Type D personality emerged as an independent predictor of increased circulating levels of both TNF-alpha (OR=9.5, 95% CI 2.1-43.8, p=.004) and TNF-alpha receptors (OR= 6.1, 95% CI 1.4-25.8, p=.014). These findings are consistent with the prognostic power of Type D personality regarding long-term morbidity and mortality in patients with established coronary heart disease. This study suggests that individual differences in personality contribute to the psychoneuroimmunological aspects of heart failure.

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  1. Kop, W.J. (1994). The predictive value of vit al exhaust ion in t he clinical course aft er coronary angioplast y . M aast richt (The Netherlands): Datawyse, Maastricht University Press.

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Authors
Denollet, J., Conraads, V. M., Brutsaert, D. L., De Clerck, L. S., Stevens, W. J., & Vrints, C. J.
Affiliations
  • Tilburg University (NL)
  • Antwerp University Hospital (BE)
Corresponding author
Denollet, Johan
Venue
Brain, Behavior, and Immunity
Publisher
Elsevier BV
Published
2003-08
Volume
17
Issue
4
Pages
304-309
ISSN
0889-1591 (ISSN-L)
OpenAlex
W2096826888
Cited by
140
References
39
Citations by year
2026: 3 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 6 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 5 · 2017: 2 · 2016: 6 · 2015: 3 · 2014: 8 · 2013: 6 · 2012: 8
FWCI
3.95
Type
journal article
Language
en
Locations
  • Brain Behavior and Immunity (publishedVersion)
  • PubMed (publishedVersion)
  • Research portal (Tilburg University) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords
Type D personality, chronic heart failure, heart failure with reduced ejection fraction, TNF-α, soluble TNF receptors, soluble tumor necrosis factor receptor 1, soluble tumor necrosis factor receptor 2, inflammation, negative affectivity, social inhibition, psychoneuroimmunology
MeSH terms
Affect, Aged, Chronic Disease, Cross-Sectional Studies, Heart Failure, Humans, Inhibition, Psychological, Male, Middle Aged, Personality Development, Tumor Necrosis Factor-alpha, Multivariate Analysis, Logistic Models, Odds Ratio, Receptors, Tumor Necrosis Factor

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