Type D personality affects health-related quality of life in patients with lone atrial fibrillation by increasing symptoms related to sympathetic activation

Nina Kupper, K.C. van den Broek, Emy Haagh, Pepijn Van Der Voort, Jos Widdershoven, Johan Denollet

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Health-related quality of life (HRQoL) is impaired in patients with atrial fibrillation (AF), and even more so in patients with a Distressed personality type (Type D). It is unknown whether this extends to patients with ‘lone AF’. Since chronic stress is associated with increased arousal, it might affect recurrences and thus HRQoL. The current study examined the influence of Type D on the trajectory of disease-specific and generic HRQoL, compared it with HRQoL in the general population, and assessed the mediating role of arousal symptoms (e.g., tachycardia, sweating).
Methods
159 patients with ‘lone AF’ (age: 61.6±0.8, 63% men, 3.3±5.0 years since diagnosis) filled out a survey on personality (Type D: DS14), quality of life (SF-36, AFQoL) and symptoms (ATSSS) of AF at inclusion, and 6, 12, and 18 months later. Linear mixed modeling was used.
Results
Generic HRQoL was reduced as compared to the general population, and all HRQoL scales remained stable across time. Type D personality was a significant predictor of worse disease-specific (estimate= -17.1 ; 95%CI:-23.9 - -10.2; p<.001), and generic HRQoL (estimatePCS=-5.5; 95%CI:-9.3 - -1.8; p=.004; estimateMCS=-14.8; 95%CI:-18.9- -10.6; p<.001), with arousal symptoms accounting for substantial change in the Type D estimate, suggesting partially shared variance between Type D and arousal symptoms in predicting HRQoL.
Conclusion
HRQoL was stable across time, and systematically poorer in distressed ‘lone AF’ patients. Arousal symptoms partly explained the relation between Type D and HRQoL. Chronic distress may affect AF patients’ HRQoL through sympathetic activation and accompanying complaints.
Original languageEnglish
Pages (from-to)44-52
JournalJournal of Psychosomatic Research
Volume115
DOIs
Publication statusPublished - 2018

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Keywords

  • AUTONOMIC NERVOUS-SYSTEM
  • CARDIOVASCULAR-DISEASE
  • HOSPITAL ANXIETY
  • ASSOCIATION
  • DEPRESSION
  • VALIDATION
  • POPULATIONS
  • OUTCOMES

Cite this

@article{47a93586150841b09dc73dc51f2975a6,
title = "Type D personality affects health-related quality of life in patients with lone atrial fibrillation by increasing symptoms related to sympathetic activation",
abstract = "BackgroundHealth-related quality of life (HRQoL) is impaired in patients with atrial fibrillation (AF), and even more so in patients with a Distressed personality type (Type D). It is unknown whether this extends to patients with ‘lone AF’. Since chronic stress is associated with increased arousal, it might affect recurrences and thus HRQoL. The current study examined the influence of Type D on the trajectory of disease-specific and generic HRQoL, compared it with HRQoL in the general population, and assessed the mediating role of arousal symptoms (e.g., tachycardia, sweating).Methods159 patients with ‘lone AF’ (age: 61.6±0.8, 63{\%} men, 3.3±5.0 years since diagnosis) filled out a survey on personality (Type D: DS14), quality of life (SF-36, AFQoL) and symptoms (ATSSS) of AF at inclusion, and 6, 12, and 18 months later. Linear mixed modeling was used.ResultsGeneric HRQoL was reduced as compared to the general population, and all HRQoL scales remained stable across time. Type D personality was a significant predictor of worse disease-specific (estimate= -17.1 ; 95{\%}CI:-23.9 - -10.2; p<.001), and generic HRQoL (estimatePCS=-5.5; 95{\%}CI:-9.3 - -1.8; p=.004; estimateMCS=-14.8; 95{\%}CI:-18.9- -10.6; p<.001), with arousal symptoms accounting for substantial change in the Type D estimate, suggesting partially shared variance between Type D and arousal symptoms in predicting HRQoL.ConclusionHRQoL was stable across time, and systematically poorer in distressed ‘lone AF’ patients. Arousal symptoms partly explained the relation between Type D and HRQoL. Chronic distress may affect AF patients’ HRQoL through sympathetic activation and accompanying complaints.",
keywords = "AUTONOMIC NERVOUS-SYSTEM, CARDIOVASCULAR-DISEASE, HOSPITAL ANXIETY, ASSOCIATION, DEPRESSION, VALIDATION, POPULATIONS, OUTCOMES",
author = "Nina Kupper and {van den Broek}, K.C. and Emy Haagh and {Van Der Voort}, Pepijn and Jos Widdershoven and Johan Denollet",
year = "2018",
doi = "10.1016/j.jpsychores.2018.10.005",
language = "English",
volume = "115",
pages = "44--52",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "PERGAMON-ELSEVIER SCIENCE LTD",

}

Type D personality affects health-related quality of life in patients with lone atrial fibrillation by increasing symptoms related to sympathetic activation. / Kupper, Nina; van den Broek, K.C.; Haagh, Emy; Van Der Voort, Pepijn; Widdershoven, Jos; Denollet, Johan.

In: Journal of Psychosomatic Research, Vol. 115, 2018, p. 44-52.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Type D personality affects health-related quality of life in patients with lone atrial fibrillation by increasing symptoms related to sympathetic activation

AU - Kupper, Nina

AU - van den Broek, K.C.

AU - Haagh, Emy

AU - Van Der Voort, Pepijn

AU - Widdershoven, Jos

AU - Denollet, Johan

PY - 2018

Y1 - 2018

N2 - BackgroundHealth-related quality of life (HRQoL) is impaired in patients with atrial fibrillation (AF), and even more so in patients with a Distressed personality type (Type D). It is unknown whether this extends to patients with ‘lone AF’. Since chronic stress is associated with increased arousal, it might affect recurrences and thus HRQoL. The current study examined the influence of Type D on the trajectory of disease-specific and generic HRQoL, compared it with HRQoL in the general population, and assessed the mediating role of arousal symptoms (e.g., tachycardia, sweating).Methods159 patients with ‘lone AF’ (age: 61.6±0.8, 63% men, 3.3±5.0 years since diagnosis) filled out a survey on personality (Type D: DS14), quality of life (SF-36, AFQoL) and symptoms (ATSSS) of AF at inclusion, and 6, 12, and 18 months later. Linear mixed modeling was used.ResultsGeneric HRQoL was reduced as compared to the general population, and all HRQoL scales remained stable across time. Type D personality was a significant predictor of worse disease-specific (estimate= -17.1 ; 95%CI:-23.9 - -10.2; p<.001), and generic HRQoL (estimatePCS=-5.5; 95%CI:-9.3 - -1.8; p=.004; estimateMCS=-14.8; 95%CI:-18.9- -10.6; p<.001), with arousal symptoms accounting for substantial change in the Type D estimate, suggesting partially shared variance between Type D and arousal symptoms in predicting HRQoL.ConclusionHRQoL was stable across time, and systematically poorer in distressed ‘lone AF’ patients. Arousal symptoms partly explained the relation between Type D and HRQoL. Chronic distress may affect AF patients’ HRQoL through sympathetic activation and accompanying complaints.

AB - BackgroundHealth-related quality of life (HRQoL) is impaired in patients with atrial fibrillation (AF), and even more so in patients with a Distressed personality type (Type D). It is unknown whether this extends to patients with ‘lone AF’. Since chronic stress is associated with increased arousal, it might affect recurrences and thus HRQoL. The current study examined the influence of Type D on the trajectory of disease-specific and generic HRQoL, compared it with HRQoL in the general population, and assessed the mediating role of arousal symptoms (e.g., tachycardia, sweating).Methods159 patients with ‘lone AF’ (age: 61.6±0.8, 63% men, 3.3±5.0 years since diagnosis) filled out a survey on personality (Type D: DS14), quality of life (SF-36, AFQoL) and symptoms (ATSSS) of AF at inclusion, and 6, 12, and 18 months later. Linear mixed modeling was used.ResultsGeneric HRQoL was reduced as compared to the general population, and all HRQoL scales remained stable across time. Type D personality was a significant predictor of worse disease-specific (estimate= -17.1 ; 95%CI:-23.9 - -10.2; p<.001), and generic HRQoL (estimatePCS=-5.5; 95%CI:-9.3 - -1.8; p=.004; estimateMCS=-14.8; 95%CI:-18.9- -10.6; p<.001), with arousal symptoms accounting for substantial change in the Type D estimate, suggesting partially shared variance between Type D and arousal symptoms in predicting HRQoL.ConclusionHRQoL was stable across time, and systematically poorer in distressed ‘lone AF’ patients. Arousal symptoms partly explained the relation between Type D and HRQoL. Chronic distress may affect AF patients’ HRQoL through sympathetic activation and accompanying complaints.

KW - AUTONOMIC NERVOUS-SYSTEM

KW - CARDIOVASCULAR-DISEASE

KW - HOSPITAL ANXIETY

KW - ASSOCIATION

KW - DEPRESSION

KW - VALIDATION

KW - POPULATIONS

KW - OUTCOMES

U2 - 10.1016/j.jpsychores.2018.10.005

DO - 10.1016/j.jpsychores.2018.10.005

M3 - Article

VL - 115

SP - 44

EP - 52

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

ER -