Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease

J. Denollet, Romy A van Felius, P. Lodder, P.M.C. Mommersteeg, Inge Goovaerts, Nadine Possemiers, Luc Vanhees, Paul Beckers, Nele Pattyn, Emeline M Van Craenenbroeck

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Abstract

Background: 

Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD).

Methods: 

At baseline, 180 CAD patients (90% men; M = 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34+/KDR+/CD45+dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function.

Results: 

Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p = 0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p = 0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD <5.5% cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65%) than non-Type Ds (63/143 = 44%); OR = 3.03, 95% CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR = 3.43, 95% CI 1.01-11.64), and in subgroup analyses of male patients.

Conclusions: 

Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.

Original languageEnglish
Pages (from-to)205-210
JournalInternational Journal of Cardiology
Volume259
DOIs
Publication statusPublished - 2018

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Dilatation
Depression
Exercise
Linear Models
Logistic Models
Endothelial Progenitor Cells

Keywords

  • CARDIOVASCULAR-DISEASE
  • Coronary artery disease
  • Depression
  • EUROPEAN-SOCIETY
  • Endothelial dysfunction
  • FLOW-MEDIATED DILATION
  • FMD
  • HEART-DISEASE
  • MENTAL STRESS
  • NEGATIVE AFFECTIVITY
  • POSITION PAPER
  • PROGENITOR CELLS
  • RISK-FACTORS
  • SOCIAL INHIBITION
  • Type D personality

Cite this

Denollet, J. ; van Felius, Romy A ; Lodder, P. ; Mommersteeg, P.M.C. ; Goovaerts, Inge ; Possemiers, Nadine ; Vanhees, Luc ; Beckers, Paul ; Pattyn, Nele ; Van Craenenbroeck, Emeline M. / Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease. In: International Journal of Cardiology. 2018 ; Vol. 259. pp. 205-210.
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title = "Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease",
abstract = "Background: Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD).Methods: At baseline, 180 CAD patients (90{\%} men; M = 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34+/KDR+/CD45+dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function.Results: Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p = 0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p = 0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD <5.5{\%} cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65{\%}) than non-Type Ds (63/143 = 44{\%}); OR = 3.03, 95{\%} CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR = 3.43, 95{\%} CI 1.01-11.64), and in subgroup analyses of male patients.Conclusions: Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.",
keywords = "CARDIOVASCULAR-DISEASE, Coronary artery disease, Depression, EUROPEAN-SOCIETY, Endothelial dysfunction, FLOW-MEDIATED DILATION, FMD, HEART-DISEASE, MENTAL STRESS, NEGATIVE AFFECTIVITY, POSITION PAPER, PROGENITOR CELLS, RISK-FACTORS, SOCIAL INHIBITION, Type D personality",
author = "J. Denollet and {van Felius}, {Romy A} and P. Lodder and P.M.C. Mommersteeg and Inge Goovaerts and Nadine Possemiers and Luc Vanhees and Paul Beckers and Nele Pattyn and {Van Craenenbroeck}, {Emeline M}",
note = "Copyright {\circledC} 2018 The Authors. Published by Elsevier B.V. All rights reserved.",
year = "2018",
doi = "10.1016/j.ijcard.2018.02.064",
language = "English",
volume = "259",
pages = "205--210",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease. / Denollet, J.; van Felius, Romy A; Lodder, P.; Mommersteeg, P.M.C.; Goovaerts, Inge; Possemiers, Nadine; Vanhees, Luc; Beckers, Paul; Pattyn, Nele; Van Craenenbroeck, Emeline M.

In: International Journal of Cardiology, Vol. 259, 2018, p. 205-210.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease

AU - Denollet, J.

AU - van Felius, Romy A

AU - Lodder, P.

AU - Mommersteeg, P.M.C.

AU - Goovaerts, Inge

AU - Possemiers, Nadine

AU - Vanhees, Luc

AU - Beckers, Paul

AU - Pattyn, Nele

AU - Van Craenenbroeck, Emeline M

N1 - Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

PY - 2018

Y1 - 2018

N2 - Background: Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD).Methods: At baseline, 180 CAD patients (90% men; M = 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34+/KDR+/CD45+dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function.Results: Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p = 0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p = 0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD <5.5% cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65%) than non-Type Ds (63/143 = 44%); OR = 3.03, 95% CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR = 3.43, 95% CI 1.01-11.64), and in subgroup analyses of male patients.Conclusions: Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.

AB - Background: Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD).Methods: At baseline, 180 CAD patients (90% men; M = 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34+/KDR+/CD45+dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function.Results: Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p = 0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p = 0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD <5.5% cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65%) than non-Type Ds (63/143 = 44%); OR = 3.03, 95% CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR = 3.43, 95% CI 1.01-11.64), and in subgroup analyses of male patients.Conclusions: Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.

KW - CARDIOVASCULAR-DISEASE

KW - Coronary artery disease

KW - Depression

KW - EUROPEAN-SOCIETY

KW - Endothelial dysfunction

KW - FLOW-MEDIATED DILATION

KW - FMD

KW - HEART-DISEASE

KW - MENTAL STRESS

KW - NEGATIVE AFFECTIVITY

KW - POSITION PAPER

KW - PROGENITOR CELLS

KW - RISK-FACTORS

KW - SOCIAL INHIBITION

KW - Type D personality

U2 - 10.1016/j.ijcard.2018.02.064

DO - 10.1016/j.ijcard.2018.02.064

M3 - Article

VL - 259

SP - 205

EP - 210

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -