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

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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

DOI 10.1016/s0889-1591(03)00060-6

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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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Denollet, 2002, Type D personality and vulnerability to chronic disease, impaired quality of life, and depressive symptoms (abstract), Psychosomatic Medicine, 64, 101
Denollet, 2002, Type D personality is associated with increased TNF-α receptor levels in patients with heart failure (abstract), Psychosomatic Medicine, 64, 152

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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
ORCID: Denollet, Johan
Conraads, Viviane M
Vrints, Christiaan J
Venue: Brain, Behavior, and Immunity
Publisher: Elsevier BV
Published: 2003-08
Volume: 17
Issue: 4
Pages: 304-309
ISSN: 0889-1591 (ISSN-L)
DOI: 10.1016/s0889-1591(03)00060-6
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: green
repository.tilburguniversity.edu
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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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Cytokines and immune activation in systolic heart failure: the role of Type D personality

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