Biochemical and histopathologic analysis of the effects of periodontitis on left ventricular heart tissues of rats

Köse, Oğuz; Arabacı, Taner; Gedikli, Semin; EMİNOĞLU, Didem ÖZKAL; Kermen, Eda; Kızıldağ, Alper; Kara, Adem; Özkanlar, Seçkin; Yemenoğlu, Hatice

doi:10.1111/jre.12380

Cited by 17 publications

(30 citation statements)

References 46 publications

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“…atrium, myocardium and aortic valve) along with the inflammatory biomarkers could further explain the connection of periodontitis and LV dysfunction (Ziebolz et al., 2018). In rats with ligature‐induced periodontitis, activated monocytes are more likely to adhere to aortic endothelia, yet these inflammatory cells could proceed to the myocardium and induce inflammatory and hypertrophic responses in the LV tissues (Kose et al., 2017; Miyajima et al., 2014). Furthermore, the mice injected with a low dose of Porphyromonas gingivalis lipopolysaccharide exhibit an increased level of cardiac troponin I and impaired cardiac function (Deleon‐Pennell, de Castro Bras, & Lindsey, 2013).…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of the effects of non‐surgical periodontal therapy on cardiac function assessed by echocardiography in type 2 diabetic patients

Wang

Liu

Zhen

et al. 2020

J Clinic Periodontology

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Background Periodontitis significantly increases the risk of diabetic complications. This clinical trial investigated the effects of periodontal therapy on cardiac function in patients with type 2 diabetes mellitus (T2DM) and periodontitis. Materials and methods Fifty‐eight subjects with T2DM and periodontitis were randomly allocated to Treatment Group (n = 29) receiving non‐surgical periodontal therapy, and Control Group (n = 29) having only oral hygiene instructions with delayed periodontal treatment until completion of this 6‐month study. The left ventricle (LV) diastolic function was assessed by echocardiography with the tissue Doppler imaging index (E/e' ratio); and LV hypertrophy was evaluated by LV mass index (LVMI). Blood samples were collected for biochemical analysis. Results The intention‐to‐treat analysis showed that periodontal treatment significantly reduced the E/e' ratio by 1.66 (95% CI: −2.64 to −0.68, p < .01), along with marked improvement of periodontal conditions (p < .05). LVMI was not altered at the 6‐month follow‐up. The serum levels of N‐terminal pro‐B type natriuretic peptide (NT‐proBNP) as a cardiac stress biomarker, C‐reactive protein and interleukin‐6 decreased numerically without reaching statistical significance. Conclusion The present study provides the first evidence that non‐surgical periodontal therapy may improve cardiac diastolic function in type 2 diabetic patients with periodontitis.

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Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of the effects of non‐surgical periodontal therapy on cardiac function assessed by echocardiography in type 2 diabetic patients

Wang

Liu

Zhen

et al. 2020

J Clinic Periodontology

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“…Indeed, it has been shown that persistent inflammation could lead to adverse effects on heart contractility, inducing hypertrophy and apoptosis . Moreover, experimental study suggested that periodontitis could induce monocytes to adhere to aortic endothelium and proceed to myocardium, inducing inflammatory and hypertrophic responses in the LV tissues …”

Section: Discussionmentioning

confidence: 99%

“…43 Moreover, experimental study suggested that periodontitis could induce monocytes to adhere to aortic endothelium and proceed to myocardium, inducing inflammatory and hypertrophic responses in the LV tissues. 44 Currently, there is no global consensus on the criteria to determine the severity of periodontitis in DM subjects. In the present study, <10% of the participants were classified as no or mild periodontitis according to the CDC-AAP case definition, 45 owing to the high prevalence and extensive nature of periodontitis in these medically compromised individuals.…”

Section: Cadmentioning

confidence: 99%

Periodontitis links to exacerbation of myocardial dysfunction in subjects with type 2 diabetes

Wang

Zhen

Liu

et al. 2019

J of Periodontal Research

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Background and Objective Subjects with diabetes and periodontitis are at high risk of cardiovascular events, while the subclinical alterations of cardiac function in this cohort remain unclear. This cross‐sectional study investigated the association of periodontitis with left ventricle (LV) structural and functional abnormalities in subjects with type 2 diabetes mellitus (T2DM). Material and Methods A total of 115 subjects with T2DM were divided into Control group (n = 32) with no or mild periodontitis, and the rest with moderate to severe chronic periodontitis (CP) were further categorized into CP‐1 (n = 41) and CP‐2 (n = 42) based on disease severity. Echocardiography was performed to precisely assess (a) LV hypertrophy by LV mass index (LVMi); (b) LV diastolic function by tissue Doppler imaging index E/e’ ratio; and (c) LV systolic function by speckle tracking derived global longitudinal strain (GLS). Results Overall, a linear trend in LVMi, E/e’, and GLS existed among the Control, CP‐1, and CP‐2 groups, respectively (P < 0.05). After adjustments of multiple confounders, CP‐2 subjects showed significantly higher E/e’ (log scale, 2.22 ± 0.05 vs 2.07 ± 0.06, P < 0.01) and GLS (−17.42 ± 0.46% vs −18.95 ± 0.54%, P < 0.05) than the Controls. Multivariate analysis revealed that sites% with probing depth ≥4 mm and sites% with clinical attachment loss ≥5 mm were independent indicators for E/e’ (β = 0.005 and β = 0.002, P < 0.01) and GLS (β = 0.03 and β = 0.02, P < 0.05) , respectively. Moreover, the number of missing teeth was significantly associated with LVMi (β = 0.01, P < 0.01). Conclusion This study provides the first evidence that severe periodontitis is significantly associated with the exacerbation of LV diastolic and systolic dysfunction in subjects with T2DM.

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“…Apical periodontitis may occur as a tissue response to pulpal infection following from dental caries, trauma, attrition from mastication, and abrasion from the use of teeth as tools . There is growing evidence that inflammatory diseases and infections may be the cause of and related to the emergence of cardiovascular problems . As an oral disease, AP is known to be a potential risk factor for cardiovascular diseases .…”

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confidence: 99%

Protective effect of alpha‐lipoic acid against apical periodontitis‐induced cardiac injury in rats

Şehirli¹,

Aksoy²,

Basmacı³

et al. 2019

European J Oral Sciences

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This study was designed to assess the possible protective effect of alpha‐lipoic acid (ALA) on apical periodontitis (AP)‐induced cardiac injury. Wistar albino rats were randomized into four groups: control; ALA; AP; and ALA + AP. Rats of the control and ALA groups were not endodontically treated, but saline and ALA (100 mg kg−1) were administered. In rats of the AP and ALA + AP groups, the pulp chambers of mandibular first molar teeth were exposed and left open for 30 d to induce AP. Saline and ALA (100 mg kg−1) were administered intraperitoneally every 24 h during the experiment. At the end of the experiment, the rats were killed. Establishment of AP was verified by radiographic and histopathological evaluation. Serum alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatine kinase (CK), and superoxide dismutase (SOD) activities were determined using an automated biochemical analyzer, and the structural cardiac injury was assessed pathologically. Serum ALP, LDH, and CK activities were elevated, and SOD activities were decreased, in the AP group. The changed enzyme activities were significantly normalized by treatment with ALA. We conclude that ALA administration alleviated the AP‐induced heart injury and improved cardiac structure and function, and therefore this agent may be of potential therapeutic value in protecting cardiac tissue from systemic injury caused by AP.

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Biochemical and histopathologic analysis of the effects of periodontitis on left ventricular heart tissues of rats

Cited by 17 publications

References 46 publications

A randomized controlled trial of the effects of non‐surgical periodontal therapy on cardiac function assessed by echocardiography in type 2 diabetic patients

A randomized controlled trial of the effects of non‐surgical periodontal therapy on cardiac function assessed by echocardiography in type 2 diabetic patients

Periodontitis links to exacerbation of myocardial dysfunction in subjects with type 2 diabetes

Protective effect of alpha‐lipoic acid against apical periodontitis‐induced cardiac injury in rats

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