Samartzis Lampros, Dimopoulos Stavros, Manetos Christos, Agapitou Varvara, Tasoulis Athanasios, Tseliou Eleni, Pozios Iraklis, Kaldara Elisavet, Terrovitis John, Nanas Serafim
Lampros Samartzis, St. George's University of London Medical School at University of Nicosia, 2408 Nicosia, Cyprus.
World J Cardiol. 2014 Oct 26;6(10):1113-21. doi: 10.4330/wjc.v6.i10.1113.
To evaluate Quality of life (QoL) in chronic heart failure (CHF) in relation to Neuroticism personality trait and CHF severity.
Thirty six consecutive, outpatients with Chronic Heart Failure (6 females and 30 males, mean age: 54 ± 12 years), with a left ventricular ejection fraction ≤ 45% at optimal medical treatment at the time of inclusion, were asked to answer the Kansas City Cardiomyopathy Questionnaire (KCCQ) for Quality of Life assessment and the NEO Five-Factor Personality Inventory for personality assessment. All patients underwent a symptom limited cardiopulmonary exercise testing on a cycle-ergometer, in order to access CHF severity. A multivariate linear regression analysis using simultaneous entry of predictors was performed to examine which of the CHF variables and of the personality variables were correlated independently to QoL scores in the two summary scales of the KCCQ, namely the Overall Summary Scale and the Clinical Summary Scale.
The Neuroticism personality trait score had a significant inverse correlation with the Clinical Summary Score and Overall Summary Score of the KCCQ (r = -0.621, P < 0.05 and r = -0.543, P < 0.001, respectively). KCCQ summary scales did not show significant correlations with the personality traits of Extraversion, Openness, Conscientiousness and Agreeableness. Multivariate linear regression analysis using simultaneous entry of predictors was also conducted to determine the best linear combination of statistically significant univariate predictors such as Neuroticism, VE/VCO2 slope and VO2 peak, for predicting KCCQ Clinical Summary Score. The results show Neuroticism (β = -0.37, P < 0.05), VE/VCO2 slope (β = -0.31, P < 0.05) and VO2 peak (β = 0.37, P < 0.05) to be independent predictors of QoL. In multivariate regression analysis Neuroticism (b = -0.37, P < 0.05), the slope of ventilatory equivalent for carbon dioxide output during exercise, (VE/VCO2 slope) (b = -0.31, P < 0.05) and peak oxygen uptake (VO2 peak), (b = 0.37, P < 0.05) were independent predictors of QoL (adjusted R2 = 0.64; F = 18.89, P < 0.001).
Neuroticism is independently associated with QoL in CHF. QoL in CHF is not only determined by disease severity but also by the Neuroticism personality trait.
评估慢性心力衰竭（CHF）患者的生活质量（QoL）与神经质人格特质及CHF严重程度之间的关系。
连续纳入36例慢性心力衰竭门诊患者（6例女性，30例男性，平均年龄：54±12岁），纳入时在最佳药物治疗下左心室射血分数≤45%，要求他们回答堪萨斯城心肌病问卷（KCCQ）以进行生活质量评估，并回答NEO五因素人格量表以进行人格评估。所有患者均在功率自行车上进行症状限制性心肺运动试验，以评估CHF严重程度。进行多变量线性回归分析，同时纳入预测因素，以检查KCCQ两个总结量表（即总体总结量表和临床总结量表）中哪些CHF变量和人格变量与QoL得分独立相关。
神经质人格特质得分与KCCQ的临床总结得分和总体总结得分呈显著负相关（分别为r = -0.621，P < 0.05和r = -0.543，P < 0.001）。KCCQ总结量表与外向性、开放性、尽责性和宜人性等人格特质无显著相关性。还进行了多变量线性回归分析，同时纳入预测因素，以确定神经质、VE/VCO2斜率和VO2峰值等具有统计学意义的单变量预测因素的最佳线性组合，用于预测KCCQ临床总结得分。结果显示神经质（β = -0.37，P < 0.05）、VE/VCO2斜率（β = -0.31，P < 0.05）和VO2峰值（β = 0.37，P < 0.05）是QoL的独立预测因素。在多变量回归分析中，神经质（b = -0.37，P < 0.05）、运动时二氧化碳排出通气当量斜率（VE/VCO2斜率）（b = -0.31，P < 0.05）和峰值摄氧量（VO2峰值）（b = 0.37，P < 0.05）是QoL的独立预测因素（调整后R2 = 0.64；F = 18.89，P < 0.001）。
神经质与CHF患者的QoL独立相关。CHF患者的QoL不仅由疾病严重程度决定，还由神经质人格特质决定。
