CoChat
Sign Up
Cited by 108Psychological Well-being and Life SatisfactionHeart Rate Variability and Autonomic ControlMindfulness and Compassion Interventions

Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure

Open access
Redwine, Laura S., Henry, Brook L., Pung, Meredith A., Wilson, Kathleen, Chinh, Kelly, Knight, Brian, Jain, Shamini, Rutledge, Thomas +3 more·2016·Psychosomatic Medicine
DOI 10.1097/psy.0000000000000316PMC PMC4927423
Open this paper in CoChat — free account

Abstract

Objective: Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Methods: Patients (n = 70; mean [standard deviation] age = 66.2 [7.6] years) were randomized to an 8-week gratitude journaling intervention or treatment as usual. Baseline (T1) assessments included the six-item Gratitude Questionnaire, resting heart rate variability (HRV), and an inflammatory biomarker index. At T2 (midintervention), the six-item Gratitude Questionnaire was measured. At T3 (postintervention), T1 measures were repeated but also included a gratitude journaling task. Results: The gratitude intervention was associated with improved trait gratitude scores (F = 6.0, p = .017, η 2 = 0.10), reduced inflammatory biomarker index score over time (F = 9.7, p = .004, η 2 = 0.21), and increased parasympathetic HRV responses during the gratitude journaling task (F = 4.2, p = .036, η 2 = 0.15), compared with treatment as usual. However, there were no resting preintervention to postintervention group differences in HRV (p values > .10). Conclusions: Gratitude journaling may improve biomarkers related to HF morbidity, such as reduced inflammation; large-scale studies with active control conditions are needed to confirm these findings. Trial Registration: Clinicaltrials.gov identifier: NCT01615094

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/psy.0000000000000316

Cites

12 of 12 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Effects of positive psychology-based programs on cardiac biomarkers or other disease markers have been mixed, with some observed effects on markers of inflammation in small trials in patients with heart failure or coronary artery disease, modest effects on glycosylated hemoglobin in small studies in diabetes, but minimal effects on other markers.

    “Effects of such programs on cardiac biomarkers (eg, inflammatory markers, heart rate variability) or other disease markers have been mixed, with some observed effects on markers of inflammation in small trials in patients with heart failure 209 or coronary artery disease, 210 modest effects on glycosylated hemoglobin in small studies in diabetes, 206,207 but minimal effects on other”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [209]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 41

  1. [1]Krum H Stewart S Chronic heart failure: time to recognize this major public health problem. The Medical journal of Australia 2006 184 147 8 16489893
  2. [2]Desai AS Stevenson LW Rehospitalization for heart failure: predict or prevent? Circulation 2012 126 501 6 22825412
  3. [3]Wang G Zhang Z Ayala C Wall HK Fang J Costs of heart failure-related hospitalizations in patients aged 18 to 64 years. Am J Manag Care 2010 16 769 76 20964473
  4. [4]Hunt SA American College of C, American Heart Association Task Force on Practice G ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2005 46 e1 82 16168273
  5. [5]Ammar KA Jacobsen SJ Mahoney DW Kors JA Redfield MM Burnett JC Jr. Rodeheffer RJ Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community. Circulation 2007 115 1563 70 17353436
  6. [6]Rozanski A Behavioral cardiology: current advances and future directions. Journal of the American College of Cardiology 2014 64 100 10 24998134
  7. [9]Sacco SJ Park CL Suresh DP Bliss D Living with heart failure: psychosocial resources, meaning, gratitude and well-being. Heart & lung: the journal of critical care 2014 43 213 8 24661743
  8. [10]Wood AM Froh JJ Geraghty AW Gratitude and well-being: a review and theoretical integration. Clin Psychol Rev 2010 30 890 905 20451313
  9. [11]Bono G Emmons RA McCullough ME Linley SJ PA Gratitude in practice and the practice of gratitude 2004 John Wiley & Sons, Inc. Hoboken, NJ, US
  10. [14]Mills PJ Redwine L Wilson K Pung MA Chinh K Greenberg BH Lunde O Maisel A Raisinghani A Wood A Chopra D The Role of Gratitude in Spiritual Well-Being in Asymptomatic Heart Failure Patients. Spirituality in Clinical Practice 2015 2 5 17 26203459 PMC4507265
  11. [15]Thayer JF Yamamoto SS Brosschot JF The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 2010 141 122 31 19910061
  12. [16]Kleiger RE Miller JP Bigger JT Moss AJ Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987 59 256 62 3812275
  13. [17]Bilchick KC Berger RD Heart rate variability. J Cardiovasc Electrophysiol 2006 17 691 4 16836727
  14. [18]Billman GE Cardiac autonomic neural remodeling and susceptibility to sudden cardiac death: effect of endurance exercise training. Am J Physiol Heart Circ Physiol 2009 297 H1171 93 19684184
  15. [19]Machado DB Crow RS Boland LL Hannan PJ Taylor HA Folsom AR Electrocardiographic findings and incident coronary heart disease among participants in the Atherosclerosis Risk in Communities (ARIC) study. Am J Cardiol 2006 97 1176 81 16616022
  16. [20]La Rovere MT Bigger JT Marcus FI Mortara A Schwartz PJ Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet 1998 351 478 84 9482439
  17. [21]Shah SA Kambur T Chan C Herrington DM Liu K Shah SJ Relation of short-term heart rate variability to incident heart failure (from the Multi-Ethnic Study of Atherosclerosis). The American journal of cardiology 2013 112 533 40 23683953 PMC3735865
  18. [22]Bouras G Giannopoulos G Hatzis G Alexopoulos D Leventopoulos G Deftereos S Inflammation and Chronic Heart Failure: From Biomarkers to Novel Anti-inflammatory Therapeutic Strategies. Medicinal chemistry 2014 25102199
  19. [23]Torre-Amione G Immune activation in chronic heart failure. Am J Cardiol 2005 95 3C 8C discussion 38C-40C 15925558
  20. [24]Bozkurt B Mann DL Deswal A Biomarkers of inflammation in heart failure. Heart Fail Rev 2010 15 331 41 19363700
  21. [25]Gullestad L Aukrust P Review of trials in chronic heart failure showing broad-spectrum anti-inflammatory approaches. Am J Cardiol 2005 95 17C 23C 15925560
  22. [27]Mccullough ME Emmons RA Tsang JA The grateful disposition: a conceptual and empirical topography. J Pers Soc Psychol 2002 82 112 27 11811629
  23. [28]Hill PL Allemand M Roberts BW Examining the Pathways between Gratitude and Self-Rated Physical Health across Adulthood. Pers Individ Dif 2013 54 92 6 23139438 PMC3489271
  24. [29]Godin G Shephard RJ A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 1985 10 141 6 4053261
  25. [30]Liu Y Zhu SH Wang GH Ye F Li PZ Validity and reliability of multiparameter physiological measurements recorded by the Equivital LifeMonitor during activities of various intensities. Journal of occupational and environmental hygiene 2013 10 78 85 23259751
  26. [32]Kent L O'Neill B Davison G Nevill A Elborn JS Bradley JM Validity and reliability of cardiorespiratory measurements recorded by the LifeShirt during exercise tests. Respiratory physiology & neurobiology 2009 167 162 7 19505672
  27. [33]Korhonen I Mainardi L Yppärilä H Musialowicz T Comparison of linear and non-linear analysis of heart rate variability in sedated cardiac surgery patients. 2001 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society Istanbul, Turkey
  28. [34]Baumert M Baier V Haueisen J Wessel N Meyerfeldt U Schirdewan A Voss A Forecasting of life threatening arrhythmias using the compression entropy of heart rate. Methods of information in medicine 2004 43 202 6 15136870
  29. [35]Hoyer D Friedrich H Zwiener U Pompe B Baranowski R Werdan K Muller-Werdan U Schmidt H Prognostic impact of autonomic information flow in multiple organ dysfunction syndrome patients. International journal of cardiology 2006 108 359 69 15979171
  30. [37]Mourot L Bouhaddi M Perrey S Cappelle S Henriet MT Wolf JP Rouillon JD Regnard J Decrease in heart rate variability with overtraining: assessment by the Poincare plot analysis. Clinical physiology and functional imaging 2004 24 10 8 14717743
  31. [38]Mourot L Bouhaddi M Perrey S Rouillon JD Regnard J Quantitative Poincare plot analysis of heart rate variability: effect of endurance training. European journal of applied physiology 2004 91 79 87 12955518
  32. [40]Hunt SA ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2005 46 e1 82 16168273
  33. [41]Linden W Gerin W Davidson K Cardiovascular reactivity: status quo and a research agenda for the new millennium. Psychosom Med 2003 65 5 8 12554811
  34. [43]Oliveira NL Ribeiro F Alves AJ Teixeira M Miranda F Oliveira J Heart rate variability in myocardial infarction patients: effects of exercise training. Rev Port Cardiol 2013 32 687 700 23993292
  35. [46]Barbour K Miller N Adherence to exercise training in heart failure: a review. Heart Fail Rev 2008 13 81 9 18008161
  36. [47]Mommersteeg PM Kupper N Schoormans D Emons W Pedersen SS Health-related quality of life is related to cytokine levels at 12 months in patients with chronic heart failure. Brain Behav Immun 2010 24 615 22 20074634
  37. [48]Araújo J Lourenço P Azevedo A Friões F Rocha-Gonçalves F Ferreira A Bettencourt P Prognostic value of high-sensitivity C-reactive protein in heart failure: a systematic review. J Card Fail 2009 15 256 66 19327628
  38. [49]Deswal A Petersen NJ Feldman AM Young JB White BG Mann DL Cytokines and cytokine receptors in advanced heart failure: an analysis of the cytokine database from the Vesnarinone trial (VEST). Circulation 2001 103 2055 9 11319194
  39. [50]Alspach G Extending the tradition of giving thanks recognizing the health benefits of gratitude. Crit Care Nurse 2009 29 12 8 19952333
  40. [51]Taylor CB Depression, heart rate related variables and cardiovascular disease. Int J Psychophysiol 2010 78 80 8 20420861
  41. [54]Lachin JM Statistical properties of randomization in clinical trials. Control Clin Trials 1988 9 289 311 3060315

Cited by

Sorted by citations

Authors
Redwine, L. S., Henry, B. L., Pung, M. A., Wilson, K., Chinh, K., Knight, B., Jain, S., Rutledge, T., Greenberg, B., Maisel, A., & Mills, P. J.
Affiliations
University of California San Diego (US)
Corresponding author
Redwine, Laura S.
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-07
Volume
78
Issue
6
Pages
667-676
ISSN
  • 0033-3174 (ISSN-L)
  • 1534-7796
DOI
10.1097/psy.0000000000000316
PMC
PMC4927423
OpenAlex
W2396652500
Cited by
108
References
12
Citations by year
2026: 6 · 2025: 10 · 2024: 10 · 2023: 6 · 2022: 13 · 2021: 14 · 2020: 17 · 2019: 9 · 2018: 11 · 2017: 10 · 2016: 1 · 2015: 1
FWCI
16.23
Type
journal article
Language
en
Open access
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • John Templeton Foundation (15627)
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (R01HL073355, T32HL007355)
Topics
  • Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords
gratitude journaling, stage B heart failure, asymptomatic heart failure, heart rate variability, parasympathetic activity, inflammatory markers, trait gratitude, inflammation, quality of life, psychosocial interventions
MeSH terms
Aged, Female, Heart Failure, Heart Rate, Humans, Inflammation, Male, Middle Aged, Pilot Projects, Psychotherapy, Severity of Illness Index, Biomarkers, Outcome Assessment, Health Care, Personal Narratives as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review