title: Occurrence of myocardial ischemia in patients undergoing pharmacologic stress echocardiography: the impact of type-d personality.
abstract: BACKGROUND
  Type-D personality has been identified as a risk factor for general and cardiac mortality in patients with coronary artery disease (CAD). Dobutamine-atropine stress echocardiography (DASE) is an established method for non-invasive evaluation of myocardial ischemia in patients with CAD. The objective of this study was to evaluate the prevalence of type-D personality and its association with the occurrence of myocardial ischemia as assessed by DASE.
  
  
  METHODS
  This case-control study enrolled 306 patients (61 ± 9.6 years, 57.8% female) who were referred by physicians to assessment of myocardial ischemia. Before undergoing DASE, the patients answered the type-D scale, which identifies type-D personality.
  
  
  RESULTS
  Type-D personality was identified in 106 patients (34.6%). DASE was positive for myocardial ischemia in 32.4% (99) of 306 participants there was no significant association between type-D personality and ischemic changes on DASE (P = 0.941; odds ratio: 0.98; confidence interval 95%: 0.57-1.69). Chest pain was the only clinical variable with statistically significant prevalence in type-D personality patients (77.4% vs. 57.0%; P < 0.001).
  
  
  CONCLUSIONS
  Type-D personality was not a significant risk factor for the presence of ischemic changes on DASE. Patients with type-D personality tended to complain more frequently of chest pain than non-type-D patients.
authors.affiliation: Departament of Echocardiography, Hospital de Clínicas, UFPR - Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Borsoi
authors.affiliation: Departament of Echocardiography, Hospital de Clínicas, UFPR - Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Viviane Vidal
authors.initials: VV
authors.lastname: Sabatoski
authors.affiliation: Departament of Echocardiography, Hospital de Clínicas, UFPR - Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Higa Ogawa
authors.affiliation: Departament of Echocardiography, Hospital de Clínicas, UFPR - Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: Fontana
authors.affiliation: PUC-PR - Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Liz Andrea
authors.initials: LA
authors.lastname: Villela Baroncini
authors.affiliation: Departament of Echocardiography, Hospital de Clínicas, UFPR - Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Admar Moraes
authors.initials: AM
authors.lastname: de Souza
authors.affiliation: Departament of Echocardiography, Hospital de Clínicas, UFPR - Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Cláudio Pereira
authors.initials: CP
authors.lastname: da Cunha
keywords: Coronary artery disease; myocardial ischemia; psychological risk factor; stress echocardiography; type-D personality
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