CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, The Netherlands; Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium.
CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, The Netherlands.
Int J Cardiol. 2018 May 15;259:205-210. doi: 10.1016/j.ijcard.2018.02.064. Epub 2018 Feb 20.
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).
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 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.
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.
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.
D 型人格（高负性情绪和社会抑制）与心血管事件和冠状动脉斑块严重程度有关。D 型人格是否也与功能性血管运动异常有关尚不清楚。我们检查了 D 型人格与冠心病（CAD）患者内皮功能障碍的并发和预测关联。
在基线时，180 名 CAD 患者（90%为男性；M=58.0 岁）完成了 D 型人格（DS14）和抑郁量表，并参加了为期 12 周的运动计划。在基线、3 个月和 12 个月时评估了肱动脉血流介导的扩张（FMD）和循环 CD34/KDR/CD45 内皮祖细胞（EPC）。使用逻辑回归和线性混合模型分析内皮功能。
D 型人格与 FMD 降低相关，无论是基线、3 个月还是 12 个月（混合模型分析，p=0.04），在调整临床特征、运动训练和抑郁后。D 型人格与 EPC 减少之间没有显著关联（p=0.07）。年龄和吸烟也是 FMD 和 EPC 的其他重要相关因素。使用 FMD<5.5%的截断值，基线时 D 型人格患者更常见内皮功能障碍（24/37=65%），而非 D 型人格患者（63/143=44%）；OR=3.03，95%CI 1.04-8.80。这一显著的 D 型人格效应在 12 个月时内皮功能障碍的前瞻性分析中得到了证实（OR=3.43，95%CI 1.01-11.64），并在男性患者的亚组分析中得到了证实。
D 型人格与 CAD 男性患者内皮功能障碍有关。这种关联在时间上是稳健的，独立于抑郁症状，支持 D 型人格对 CAD 患者心血管健康有不良影响的观点。
