title: Association between type D personality, depression, and oxidative stress in patients with chronic heart failure.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medical Psychology, Tilburg University, Center of Research on Psychology in Somatic diseases, Warandelaan 2, PO box 90153, 5000 LE Tilburg, Netherlands. h.m.kupper@uvt.nl
authors.forename: Nina
authors.initials: N
authors.lastname: Kupper
authors.forename: Yori
authors.initials: Y
authors.lastname: Gidron
authors.forename: Jobst
authors.initials: J
authors.lastname: Winter
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: D000080242:8-Hydroxy-2'-Deoxyguanosine; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015897:Comorbidity; D004249:DNA Damage / Q000502:physiology; D003849:Deoxyguanosine / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism; D003865:Major Depressive Disorder / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D050884:HSP72 Heat-Shock Proteins / Q000097:blood / Q000378:metabolism; D006304:Health Status; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology*; D010551:Personality / Q000145:classification*; D010555:Personality Inventory; D012307:Risk Factors; D013315:Stress, Psychological / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D014969:Xanthine Oxidase / Q000097:blood
chemical_list: D015415:Biomarkers; D050884:HSP72 Heat-Shock Proteins; D000080242:8-Hydroxy-2'-Deoxyguanosine; D014969:Xanthine Oxidase; D003849:Deoxyguanosine