Association Between Type D Personality, Depression, and Oxidative Stress in Patients With Chronic Heart Failure
Abstract
Objective: To examine whether markers of oxidative stress differ as a function of Type D personality, depression, and chronic heart failure (CHF) etiology. Type D (distressed) personality and depression are related to poor cardiac prognosis. Because patients with CHF are characterized by increased oxidative stress, this may be a candidate mechanism responsible for the adverse prognosis in emotionally distressed patients with CHF. Methods: Serum levels of xanthine oxidase (XO), inducible heat shock protein (Hsp)70, and deoxyribonucleic acid damage marker 8-OHdG were measured in 122 patients, and effects of Type D, depression, and etiology were assessed. Results: CHF patients with Type D personality had lower levels of Hsp70 than non-Type D patients (6.48 ng/mL versus 7.85 ng/mL, p = .04, d = 0.26), and in case of an ischemic etiology, higher levels of XO (13.57 ng/mL versus 9.84 ng/mL, p = .01, d = 0.98). There were no significant univariate differences for depression. When adding depression as an additional independent variable in the Type D analysis, the effect of Type D personality remained significant (F = 5.460, p = .02) and was independent of depression (F = 0.942, p = .33). The ratio of XO to Hsp70 was significantly higher in Type D patients with CHF as compared with non-Type D patients (6.14 versus 2.83, p = .03, d = 0.39), independent of etiology class. Conclusion: CHF patients with Type D personality are characterized by an increased oxidative stress burden, apparent in the decreased antioxidant levels and an increased oxidative stress ratio. 8-OHdG = 8-hydroxy-2-deoxyguanosine; ACE = angiotensin-converting enzyme; CHF = chronic heart failure; ELISA = enzyme-linked immunosorbent assay; HF = heart failure; Hsp70 = heat shock protein 70; LVEF = left ventricular ejection fraction; MANOVA = multivariate analysis of variance; MDD = major depressive disorder; MI = myocardial infarction; NA = negative affectivity; ROS = reactive oxygen species; SI = social inhibition; TNF = tumor necrosis factor; XO = xanthine oxidase.
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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 [150]
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 [150]
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 [151]
Type D is associated with oxidative stress.
“and oxidative stress [151]”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [151]
Type D personality was associated with elevations in inflammatory cytokines comparable to elevations conferred by 10 years of aging.
“Another found that Type D personality was associated with elevations in inflammatory cytokines that was comparable to elevations conferred by 10 years of aging [150].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [150]
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BackgroundResultCzarny, P., Kwiatkowski, D., Toma, M., Kubiak, J., Sliwinska, A., Talarowska, M., Szemraj, J., Maes, M., Galecki, P., & Sliwinski, T. (2017) · Molecular Neurobiology · doi:10.1007/s12035-016-9971-6 · Cited by 43 · see citing works
- Authors
- Kupper, N., Gidron, Y., Winter, J., & Denollet, J.
- Affiliations
- Tilburg University (NL)
- Elisabeth-TweeSteden Ziekenhuis (NL)
- Corresponding author
- Kupper, Nina
- Venue
- Psychosomatic Medicine
- Published
- 2009-11
- Volume
- 71
- Issue
- 9
- Pages
- 973-980
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2131302673
- Cited by
- 85
- References
- 56
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 5 · 2018: 8 · 2017: 8 · 2016: 12 · 2015: 11 · 2014: 5 · 2013: 9 · 2012: 5
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- Research portal (Tilburg University) (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- Type D personality, depression, chronic heart failure, oxidative stress, xanthine oxidase, HSP70, 8-hydroxy-2'-deoxyguanosine, heart failure etiology, ischemic heart failure, antioxidant status, negative affectivity, social inhibition, major depressive disorder, biomarkers, reactive oxygen species, TNF-α, angiotensin-converting enzyme
- MeSH terms
- 8-Hydroxy-2'-Deoxyguanosine, Aged, Chronic Disease, Deoxyguanosine, Major Depressive Disorder, DNA Damage, Enzyme-Linked Immunosorbent Assay, Female, Health Status, Heart Failure, Humans, Male, Myocardial Infarction, Personality, Personality Inventory, Risk Factors, Stress, Psychological, Xanthine Oxidase, Biomarkers, Comorbidity, Oxidative Stress, HSP72 Heat-Shock Proteins
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