Association between type D personality, depression, and oxidative stress in patients with chronic heart failure

• Published in: Psychosomatic medicine 2009-11, Vol.71 (9), p.973-980
• Main Authors: Kupper, Nina, Gidron, Yori, Winter, Jobst, Denollet, Johan
• Format: Article
• Language: English
• Subjects: Aetiology; Aged; Biomarkers - blood; Chronic Disease; Comorbidity; Deoxyguanosine - analogs & derivatives; Deoxyguanosine - blood; Deoxyguanosine - metabolism; Depression; Depressive Disorder, Major - blood; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - epidemiology; DNA Damage - physiology; Enzyme-Linked Immunosorbent Assay; Female; Health Status; Heart failure; Heart Failure - blood; Heart Failure - diagnosis; Heart Failure - epidemiology; HSP72 Heat-Shock Proteins - blood; HSP72 Heat-Shock Proteins - metabolism; Humans; Male; Medical prognosis; Mental depression; Myocardial Infarction - blood; Myocardial Infarction - metabolism; Oxidation; Oxidative stress; Oxidative Stress - physiology; Patients; Personality; Personality - classification; Personality Inventory; Prognosis; Proteins; Psychosomatic medicine; Risk Factors; Stress, Psychological - blood; Stress, Psychological - diagnosis; Stress, Psychological - epidemiology; Xanthine Oxidase - blood
• ISSN: 0033-3174; 1534-7796
• DOI: 10.1097/PSY.0b013e3181bee6dc

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. 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. 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. 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.