J Periodontal Implant Sci.  2021 Aug;51(4):226-238. 10.5051/jpis.2006040302.

Association between periodontal bacteria and degenerative aortic stenosis: a pilot study

• Kataoka A
• Katagiri S
• Kawashima H
• Nagura F
• Nara Y
• Hioki H
• Nakashima M
• Sasaki N
• Hatasa M
• Maekawa S
• Ohsugi Y
• Shiba T
• Watanabe Y
• Shimokawa T
• Iwata T
• Kozuma K

• KMID: 2557502
• DOI: http://doi.org/10.5051/jpis.2006040302

Abstract

Purpose
Although several reports have described the relationship between periodontal disease and cardiovascular disease, information about the association between periodontal disease and the progression of degenerative aortic stenosis (AS) is lacking. Therefore, we performed a retrospective, single-center, pilot study to provide insight into this potential association.
Methods
Data from 45 consecutive patients (19 men; median age, 83 years) with mild or moderate degenerative aortic stenosis were analyzed for a mean observation period of 3.3±1.9 years. The total amount of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis and titers of serum immunoglobulin G (IgG) against periodontal bacteria and high-sensitivity C-reactive protein (hs-CRP) were evaluated. Aortic valve area (AVA), maximal velocity (Vmax), mean pressure gradient (mean PG), and the Doppler velocity index (DVI) were evaluated. The change in each parameter per year ([Parameter _LATEST –Parameter _BASELINE ]/Follow-up Years) was calculated from the retrospective follow-up echocardiographic data (baseline vs. the most recently collected data [latest]).
Results
No correlation was found between the concentration of periodontopathic bacteria in the saliva and AS status/progression. The anti-P. gingivalis antibody titer in the serum showed a significant positive correlation with AVA and DVI. Additionally, there was a negative correlation between the anti-P. gingivalis IgG antibody titer and mean PG. The hs-CRP concentration showed positive correlations with Vmax and mean PG. Meanwhile, a negative correlation was observed between the anti-P. gingivalis IgG antibody titer and ΔAVA/year and Δmean PG/year. The hs-CRP concentration showed positive correlations with Vmax and mean PG, and it was significantly higher in patients with rapid aortic stenosis progression (ΔAVA/year <−0.1) than in their counterparts.
Conclusions
Our results suggest that periodontopathic bacteria such as A. actinomycetemcomitans and P. gingivalis are not directly related to the status/progression of degenerative AS. However, inflammation and a lower immune response may be associated with disease progression.

Keyword

Aortic valve stenosis; C-reactive protein; Periodontal diseases; Porphyromonas gingivalis