Alexithymic, socially inhibited persons and the risk for rhythm disturbances in cardiac surgery patients

Abstract

Objectives: This study tests the hypothesis that some personality types are linked to autonomic imbalance in cardiac surgery (CS) pts. Methods: A sample of 218 pts (154 men and 64 women, aged 59.1±9.8 years) were investigated two months after CS. TAS-20, JAS-SF, hostility subscale of the SCL-90R, DS-14 were used for the estimation of alexithymia, type A behavior, hostility,D-type personality and negative affectivity, social inhibition (D-type subscales). The high-frequency component (HFC%), the low to high-frequency ratio (LFC/HFC) and maximal heart rate reaction to active orhostatic test (DltRRBms) of the spectral heart rate variability (HRV) analysis were used as markers of parasympathetic and sympathetic activity. Results: This study demonstrates that 135 (75.4%) pts. have increased sympathetic activity (LFC/HFC ratio 1.1, DltRRbb200ms) and 107 (61.1%) pts. have decreased parasympathetic activity (HFC%b19.99%). Ttests did not show any differences in HRV markers means between different personality types subgroups. However, the results of multiple regression analysis have revealed significant association between LFC/HFC ratio and TAS-20 score (p=0.045, F=4.071), and negative DltRRbms relation to social inhibition subscale score (p=0.022, F=5.318). Also, the tendency for negative association between TAS-20 and HFC% was estimated, but it was not significant. Conclusions: HRV parameters can be a useful noninvasive method that may detect autonomic nervous system imbalance and identify pts. at risk of rhythm disturbances and sudden death. The risk for autonomic imbalance is greater in alexithymic and in socially inhibited persons after CS. Psychological rehabilitation is needed for such personalities.