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

Akihisa Kataoka; Sayaka Katagiri; Hideyuki Kawashima; Fukuko Nagura; Yugo Nara; Hirofumi Hioki; Makoto Nakashima; Naoki Sasaki; Masahiro Hatasa; Shogo Maekawa; Yujin Ohsugi; Takahiko Shiba; Yusuke Watanabe; Tomoki Shimokawa; Takanori Iwata; Ken Kozuma

doi:10.5051/jpis.2006040302

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

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

Authors

Affiliations

¹ Division of Cardiology, Department of Medicine, Teikyo University, Tokyo, Japan. kataoaki@sd5.so-net.ne.jp.
² Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. katagiri.peri@tmd.ac.jp.
³ Division of Cardiology, Department of Medicine, Teikyo University, Tokyo, Japan.
⁴ Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
⁵ Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan.

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.

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

Abstract

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