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European Heart Journal Advance Access published online on April 12, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi252
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received August 23, 2004
Revised January 28, 2005
Accepted March 3, 2005

Clinical research

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

Clara Carpeggiani 1*, Michele Emdin 1, Franco Bonaguidi 1, Patrizia Landi 1, Claudio Michelassi 1, Maria Giovanna Trivella 1, Alberto Macerata 2, and Antonio L'Abbate 3

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

* To whom correspondence should be addressed.
Clara Carpeggiani, E-mail: clara{at}ifc.cnr.it


  Abstract

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.

Keywords: Risk factors; Myocardial infarction; Prognosis; Heart rate variability.
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