Observational Study
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World J Cardiol. Oct 26, 2014; 6(10): 1113-1121
Published online Oct 26, 2014. doi: 10.4330/wjc.v6.i10.1113
Neuroticism personality trait is associated with Quality of Life in patients with Chronic Heart Failure
Lampros Samartzis, Stavros Dimopoulos, Christos Manetos, Varvara Agapitou, Athanasios Tasoulis, Eleni Tseliou, Iraklis Pozios, Elisavet Kaldara, John Terrovitis, Serafim Nanas
Lampros Samartzis, St. George’s University of London Medical School at University of Nicosia, 2408 Nicosia, Cyprus
Lampros Samartzis, Department of Psychiatry, Nicosia Mental Health Services, Athalassa Psychiatric Hospital, 1432 Nicosia, Cyprus
Lampros Samartzis, Stavros Dimopoulos, Christos Manetos, Varvara Agapitou, Athanasios Tasoulis, Serafim Nanas, 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, “Evgenidio” Hospital, National and Kapodistrian University of Athens, 15128 Athens, Greece
Eleni Tseliou, Iraklis Pozios, Elisavet Kaldara, John Terrovitis, 3rd Cardiology Department, “Laiko” Hospital, National and Kapodistrian University of Athens, 15128 Athens, Greece
Author contributions: Samartzis L, Dimopoulos S and Nanas S designed the experiments; Manetos C, Agapitou V, Tasoulis A, Tseliou E, Pozios I and Kaldara E prepared the experiments; Samartzis L and Dimopoulos S prepared the manuscript; Terrovitis J and Nanas S revised and approved the final version of the manuscript.
Correspondence to: Stavros Dimopoulos, MD, 1st Critical Care Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, “Evgenidio” Hospital, National and Kapodistrian University of Athens, 20, Papadiamantopoulou str, 15128 Athens, Greece. a-icu@med.uoa.gr
Telephone: +30-697-3956974 Fax: +30-210-7242785
Received: May 15, 2014
Revised: August 7, 2014
Accepted: September 16, 2014
Published online: October 26, 2014
Processing time: 174 Days and 6.9 Hours
Abstract

AIM: To evaluate Quality of life (QoL) in chronic heart failure (CHF) in relation to Neuroticism personality trait and CHF severity.

METHODS: Thirty six consecutive, outpatients with Chronic Heart Failure (6 females and 30 males, mean age: 54 ± 12 years), with a left ventricular ejection fraction ≤ 45% at optimal medical treatment at the time of inclusion, were asked to answer the Kansas City Cardiomyopathy Questionnaire (KCCQ) for Quality of Life assessment and the NEO Five-Factor Personality Inventory for personality assessment. All patients underwent a symptom limited cardiopulmonary exercise testing on a cycle-ergometer, in order to access CHF severity. A multivariate linear regression analysis using simultaneous entry of predictors was performed to examine which of the CHF variables and of the personality variables were correlated independently to QoL scores in the two summary scales of the KCCQ, namely the Overall Summary Scale and the Clinical Summary Scale.

RESULTS: The Neuroticism personality trait score had a significant inverse correlation with the Clinical Summary Score and Overall Summary Score of the KCCQ (r = -0.621, P < 0.05 and r = -0.543, P < 0.001, respectively). KCCQ summary scales did not show significant correlations with the personality traits of Extraversion, Openness, Conscientiousness and Agreeableness. Multivariate linear regression analysis using simultaneous entry of predictors was also conducted to determine the best linear combination of statistically significant univariate predictors such as Neuroticism, VE/VCO2 slope and VO2 peak, for predicting KCCQ Clinical Summary Score. The results show Neuroticism (β = -0.37, P < 0.05), VE/VCO2 slope (β = -0.31, P < 0.05) and VO2 peak (β = 0.37, P < 0.05) to be independent predictors of QoL. In multivariate regression analysis Neuroticism (b = -0.37, P < 0.05), the slope of ventilatory equivalent for carbon dioxide output during exercise, (VE/VCO2 slope) (b = -0.31, P < 0.05) and peak oxygen uptake (VO2 peak), (b = 0.37, P < 0.05) were independent predictors of QoL (adjusted R2 = 0.64; F = 18.89, P < 0.001).

CONCLUSION: Neuroticism is independently associated with QoL in CHF. QoL in CHF is not only determined by disease severity but also by the Neuroticism personality trait.

Keywords: Chronic heart failure; Five-Factor Personality Inventory; Kansas City Cardiomyopathy Questionnaire; Quality of Life

Core tip: Of the patients with chronic heart failure (CHF), those who are experiencing low Quality of Life (QoL) show higher morbidity, hospitalization rates and mortality. There is a link between low QoL, low adherence to pharmaceutical and non-pharmaceutical treatment as well as exercise training rehabilitation, and high anxiety and depression levels. The personality of the patient has been also found to play a role in affecting QoL and therefore prognosis. Taking into account that the personality trait of Neuroticism, has been found to affect QoL in chronically ill individuals, this study explores its possible role in predicting QoL in CHF population in relation to disease severity.