Cytokines and immune activation in systolic heart failure: the role of Type D personality
Open accessAbstract
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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Inflammatory markers and oxidative stress both contribute to the progression of CVD.
“which both contribute to the progression of CVD.”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [149]
Type D is associated with inflammatory markers.
“As well, Type D is associated with inflammatory markers [147–150]”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [149]
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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
- Open access
- Licence
- 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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