PMID- 18068948 OWN - NLM STAT- MEDLINE DCOM- 20080819 LR - 20080616 IS - 1090-2139 (Electronic) IS - 0889-1591 (Linking) VI - 22 IP - 5 DP - 2008 Jul TI - Comparing Type D personality and older age as correlates of tumor necrosis factor-alpha dysregulation in chronic heart failure. PG - 736-43 AB - Tumor necrosis factor-alpha (TNF-alpha) and its soluble receptors 1 (sTNFR1) and 2 (sTNFR2) have been shown to be implicated in the pathogenesis of chronic heart failure (CHF). Ageing is accompanied by increased plasma levels of pro-inflammatory cytokines. We hypothesized that Type D personality (joint tendency to experience negative emotions and to inhibit self-expression) and age may have similar pro-inflammatory effects in the context of CHF. Participants in this study were 130 consecutive outpatients with CHF (76% men); there were 70 relatively younger (or=60 years) patients. They all completed the 14-item Type D Scale (DS14); 43 patients (33%) had a Type D personality. A multivariate model of cytokine levels indicated an independent overall effect of both older age [F(1,128)=9.11, p=.003] and Type D personality [F(1,128)=8.28, p=.005]. Stratifying patients in age/personality subgroups showed that younger non-Type D patients had the lowest and older Type D patients the highest sTNFR1 and sTNFR2 levels (986+/-318 vs 1661+/-1128 pg/ml and 1838+/-777 vs 2823+/-1439 pg/ml, p<.0001). Importantly, the mean sTNFR1 level in younger Type D patients (1359+/-660 pg/ml) was equivalent to that in older non-Type D patients (1360+/-440 pg/ml, p=.99) who were on average 18 years older. Younger Type D and older non-Type D patients also had similar sTNFR2 levels (2406+/-1329 vs 2448+/-812 pg/ml, p=.88). Only older Type D patients had a higher mean TNF-alpha level as compared to patients who were younger or who were not Type D (5.4+/-2.9 vs 3.9+/-2.4 pg/ml, p=.008). A logistic regression model including sex, severity of CHF, systolic heart failure and ischemic etiology indicated that the combined risk category of older age or Type D was independently associated with substantially increased sTNFR1 and sTNFR2 levels. Hence, Type D personality was associated with increased TNF-alpha activity. This disease-promoting effect of Type D matched the pro-inflammatory effect of ageing. FAU - Denollet, Johan AU - Denollet J AD - CoRPS-Centre of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands. denollet@uvt.nl FAU - Vrints, Christiaan J AU - Vrints CJ FAU - Conraads, Viviane M AU - Conraads VM LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20080220 PL - Netherlands TA - Brain Behav Immun JT - Brain, behavior, and immunity JID - 8800478 RN - 0 (Cytokines) RN - 0 (Receptors, Tumor Necrosis Factor, Type I) RN - 0 (Receptors, Tumor Necrosis Factor, Type II) RN - 0 (Tumor Necrosis Factor-alpha) SB - IM MH - Adult MH - Age Factors MH - Aged MH - Chronic Disease MH - Cytokines/blood/metabolism MH - Enzyme-Linked Immunosorbent Assay MH - Female MH - Heart Failure/blood/*pathology/psychology MH - Humans MH - Male MH - Middle Aged MH - Personality/classification/*physiology MH - Personality Assessment/standards/statistics & numerical data MH - Receptors, Tumor Necrosis Factor, Type I/*blood/metabolism MH - Receptors, Tumor Necrosis Factor, Type II/*blood/metabolism MH - Regression Analysis MH - Risk Factors MH - Tumor Necrosis Factor-alpha/*blood/metabolism EDAT- 2007/12/11 09:00 MHDA- 2008/08/20 09:00 CRDT- 2007/12/11 09:00 PHST- 2007/08/27 00:00 [received] PHST- 2007/10/26 00:00 [revised] PHST- 2007/10/27 00:00 [accepted] PHST- 2007/12/11 09:00 [pubmed] PHST- 2008/08/20 09:00 [medline] PHST- 2007/12/11 09:00 [entrez] AID - S0889-1591(07)00271-1 [pii] AID - 10.1016/j.bbi.2007.10.015 [doi] PST - ppublish SO - Brain Behav Immun. 2008 Jul;22(5):736-43. doi: 10.1016/j.bbi.2007.10.015. Epub 2008 Feb 20.