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European Heart Journal Advance Access originally published online on April 12, 2005
European Heart Journal 2005 26(16):1612-1617; doi:10.1093/eurheartj/ehi252
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Personality traits and heart rate variability predict long-term cardiac mortality after myocardial infarction

Clara Carpeggiani1,*, Michele Emdin1, Franco Bonaguidi1, Patrizia Landi1, Claudio Michelassi1, Maria Giovanna Trivella1, Alberto Macerata2 and Antonio L'Abbate3

1CNR Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy
2Department of Internal Medicine, University of Pisa, Pisa, Italy
3Scuola Superiore Sant'Anna, Pisa, Italy

Received 23 August 2004; revised 28 January 2005; accepted 3 March 2005; online publish-ahead-of-print 12 April 2005.

* Corresponding author. Tel: +39 0503152005; fax: +39 0503152166. E-mail address: clara{at}ifc.cnr.it

Aims To investigate personality traits and sympatho-vagal modulation of heart rate variability (HRV) during acute myocardial infarction (AMI), assessing their relationships and their long-term prognostic value.

Methods and results Psychological traits and 24 h HRV were prospectively investigated in 246 patients at discharge of an AMI. Patients were followed-up to 8 years for the occurrence of cardiac death and non-fatal reinfarction. Low coping and anxiety traits associated with reduced HRV characterized the study population. At univariate analysis, low emotional sensitivity and insecurity, relative tachycardia, reduced high frequency (HF), and low frequency power and pNN50 were predictive of cardiac death at 8-year follow-up. At multivariable analysis, low emotional sensitivity and low HF power remained predictive, with a relative risk of 4.18 (P=0.003) and 2.76 (P=0.007), respectively; also the type of infarction (Q vs. non-Q) and hospital length of stay were independent predictive variables.

Conclusion Anxiety and emotional sensitivity were significant predictors of 8-year cardiac mortality after AMI. Reduced HF power, a recognized marker of vagal withdrawal, increased the risk.

Key Words: Risk factors • Myocardial infarction • Prognosis • Heart rate variability


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