Heart rate recovery after exercise in chronic heart failure: Role of vital exhaustion and type D personality

von Känel, Roland; Barth, Jürgen; Kohls, Sonja; Saner, Hugo; Znoj, Hansjörg; Saner, Gaby; Schmid, Jean-Paul (2009). Heart rate recovery after exercise in chronic heart failure: Role of vital exhaustion and type D personality. Journal of cardiology, 53(2), pp. 248-256. Tokyo: Elsevier 10.1016/j.jjcc.2008.11.008

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OBJECTIVE: Vital exhaustion and type D personality previously predicted mortality and cardiac events in patients with chronic heart failure (CHF). Reduced heart rate recovery (HRR) also predicts morbidity and mortality in CHF. We hypothesized that elevated levels of vital exhaustion and type D personality are both associated with decreased HRR. METHODS: Fifty-one patients with CHF (mean age 58+/-12 years, 82% men) and left ventricular ejection fraction (LVEF) </=40% underwent standard exercise testing before receiving outpatient cardiac rehabilitation. They completed the 9-item short form of the Maastricht Vital Exhaustion Questionnaire and the 14-item type D questionnaire asking about negative affectivity and social inhibition. HRR was calculated as the difference between heart rate at the end of exercise and 1min after abrupt cessation of exercise (HRR-1). Regression analyses were adjusted for gender, age, LVEF, and maximum exercise capacity. RESULTS: Vital exhaustion explained 8.4% of the variance in continuous HRR-1 (p=0.045). For each point increase on the vital exhaustion score (range 0-18) there was a mean+/-SEM decrease of 0.54+/-0.26bpm in HRR-1. Type D personality showed a trend toward statistical significance for being associated with lower levels of HRR-1 explaining 6.5% of the variance (p<0.08). The likelihood of having HRR-1</=18bpm was significantly higher in patients with type D personality than in those without (odds ratio=7.62, 95% CI 1.50-38.80). CONCLUSIONS: Elevated levels of vital exhaustion and type D personality were both independently associated with reduced HRR-1. The findings provide a hitherto not explored psychobiological explanation for poor cardiac outcome in patients with CHF.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

von Känel, Roland; Barth, Jürgen; Saner, Hugo and Schmid, Jean-Paul

ISSN:

0914-5087

ISBN:

19304130

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:09

Last Modified:

21 Jul 2015 15:11

Publisher DOI:

10.1016/j.jjcc.2008.11.008

PubMed ID:

19304130

Web of Science ID:

000265008700014

BORIS DOI:

10.7892/boris.30195

URI:

https://boris.unibe.ch/id/eprint/30195 (FactScience: 191354)

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