Facial expressions of emotions during pharmacological and exercise stress testing:The role of myocardial ischemia and cardiac symptoms

Background  Negative emotions have been linked to ischemic heart disease, but existing research typically involves self-report methods and little is known about non-verbal facial emotion expression. The role of ischemia and anginal symptoms in emotion expression was examined.  Methods  Patients undergoing cardiac stress testing (CST) using bicycle exercise or adenosine with myocardial perfusion imaging were included (N = 256, mean age 66.8 +/- 8.7 year., 43% women). Video images and emotion expression (sadness, anxiety, anger, and happiness) were analyzed at baseline, initial CST , maximal CST, recovery. Nuclear images were evaluated using SPECT.  Results  Ischemia (N = 89; 35%) was associated with higher levels of sadness (p = .017, d = 0.34) and lower happiness (p = .015, d = 0.30). During recovery, patients with both ischemia and anginal symptoms had the highest sadness expression (F (3,254) = 3.67, p = .013, eta(2) = 0.042) and the lowest happiness expression (F (3, 254) = 4.19, p = .006, eta(2) = .048).  Conclusion  Sadness and reduced happiness were more common in patients with ischemia. Also, anginal symptoms were associated with more negative emotions

Type D Personality, Temperament, and Mental Health in Military Personnel Awaiting Deployment

Type D personality, temperament, and mental health in military personnel awaitin

Type D personality is associated with increased metabolic syndrome prevalence and an unhealthy lifestyle in a cross-sectional Dutch community sample

<p>Abstract</p> <p>Background</p> <p>People with Type D-Distressed-personality have a general tendency towards increased negative affectivity (NA), while at the same time inhibiting these emotions in social situations (SI). Type D personality is associated with an increased risk of adverse outcomes in patients with cardiovascular disease. Whether Type D personality is a cardiovascular risk factor in healthy populations remains to be investigated. In the present study, the relations between Type D personality and classical cardiovascular risk factors, i.e. metabolic syndrome and lifestyle were investigated in a Dutch community sample.</p> <p>Methods</p> <p>In a cross-sectional study 1592 participants were included, aged 20-80 years. Metabolic syndrome was defined by self-report, following the International Diabetes Federation-IDF-guidelines including an increased waist circumference, dyslipidemia, hypertension, and diabetes. In addition lifestyle factors smoking, alcohol use, exercise and dietary habits were examined. Metabolic syndrome prevalence was stratified by Type D personality (a high score on both NA and SI), lifestyle and confounders age, gender, having a partner, higher education level, cardiac history, family history of cardiovascular disease.</p> <p>Results</p> <p>Metabolic syndrome was more prevalent in persons with a Type D personality (13% vs. 6%). Persons with Type D personality made poorer lifestyle choices, adhered less to the physical activity norm (OR = 1.5, 95%CI = 1.1-2.0, <it>p </it>= .02), had a less varied diet (OR = 0.50, 95%CI = 0.40-0.70, <it>p </it>< .0005), and were less likely to restrict their fat intake (OR = 0.70, 95%CI = 0.50-0.90, <it>p </it>= .01). Type D personality was related to a twofold increased risk of metabolic syndrome (OR = 2.2, 95%CI = 1.2-4.0, <it>p </it>= .011), independent of lifestyle factors and confounders.</p> <p>Conclusions</p> <p>Type D personality is related to an increased prevalence of metabolic syndrome and unhealthy lifestyle, which suggests both behavioral and biological vulnerability for development of cardiovascular disorders and diabetes.</p

Stress and Biological pathways of health and disease

This chapter provides a general overview and introduces concepts related to major biological pathways involved in how stress, and other psychological factors can affect health outcomes. We start with scientists who have introduced the key terms and concepts of the field by investigating how stress affects our functioning, and present a psychosomatic model of disease. In the subsequent parts three major biological pathways are discussed. 1. Autonomic functioning of the sympathetic nervous system with adrenaline as the excitatory stress hormone, and the parasympathetic nervous system involved in rest. 2. The hypothalamus-pituitary-adrenal (HPA) axis with cortisol as a regulatory hormone. 3. The immune system affects our ability to conquer disease. The immune system is also affected by stress and psychological states, having a large effect on health and disease. Finally, a combination of these three major regulatory mechanisms is integrated and measurement issues and pitfalls are discussed

Stress and Biological pathways of health and disease

This chapter provides a general overview and introduces concepts related to major biological pathways involved in how stress, and other psychological factors can affect health outcomes. We start with scientists who have introduced the key terms and concepts of the field by investigating how stress affects our functioning, and present a psychosomatic model of disease. In the subsequent parts three major biological pathways are discussed. 1. Autonomic functioning of the sympathetic nervous system with adrenaline as the excitatory stress hormone, and the parasympathetic nervous system involved in rest. 2. The hypothalamus-pituitary-adrenal (HPA) axis with cortisol as a regulatory hormone. 3. The immune system affects our ability to conquer disease. The immune system is also affected by stress and psychological states, having a large effect on health and disease. Finally, a combination of these three major regulatory mechanisms is integrated and measurement issues and pitfalls are discussed

Health-related quality of life is related to cytokine levels at 12 months in patients with chronic heart failure

Chronic heart failure (CHF) is a condition with a high mortality risk. Besides traditional risk factors, poor health-related quality of life (HRQoL) is also associated with poor prognosis in CHF. Immunological functioning might serve as a biological pathway underlying this association, since pro and anti-inflammatory cytokines are independent predictors of prognosis. The aim of this study was to examine the association between HRQoL at inclusion (baseline) and pro and anti-inflammatory cytokine levels both at baseline and 12months, using a prospective study design. CHF outpatients completed the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Short Form Health Survey 36 (SF-36). Blood samples were drawn at baseline (n=111) and 12months (n=127) to measure pro (IL-6, TNFalpha, sTNFR1, sTNFR2) and anti- (IL1ra, IL-10) inflammatory markers. Linear regression analysis were run for the MLHFQ, the SF-36 mental component summary (MCS) and the physical component summary (PCS), controlling for age, sex, BMI, smoking, co morbidity, NYHA-class and 6min walk test. Baseline MLHFQ was associated with increased levels of baseline sTNFR2, and 12-month sTNFR1 12month sTNFR2. Baseline MCS and change in MCS were related to increased 12-month sTNFR1 levels. All significant findings relate a worse HRQoL at baseline or a deterioration over time to increased sTNFR1/2 levels. These findings suggest that immune activation may be one of the pathways underlying the relationship between poor HRQoL and mortality and morbidity in CHF patients. Future studies are warranted to replicate these findings in larger samples