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

1 Citation (Scopus)

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

Keywords

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

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