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Periodontitis - A modifiable risk factor for Atrial Fibrillation, finds study
A recent investigation found that there is a histological association between periodontitis and atrial fibrosis, and it is a modifiable risk factor for atrial fibrillation. The study was published in the journal JACC: Clinical Electrophysiology.
Atrial fibrosis is one of the contributing factors to the onset and persistence of atrial fibrillation (AF) and AF-related stroke. Periodontitis which is a common infectious and inflammatory disease of the gums aggravates some systemic diseases. Though previous literature shows that periodontitis can cause systemic diseases there is uncertainty on the association of periodontitis with AF and with atrial fibrosis. Hence researchers conducted a study on resected left atrial appendages (LAAs) to elucidate the relationship between periodontitis and atrial fibrosis.
A prospective study was conducted on Seventy-six patients with AF who were undergoing LAA excision during cardiac surgery. AF patients included 55 with nonparoxysmal AF, 25 with mitral valve regurgitation, and 18 with LAA thrombus. All patients underwent an oral examination, and an evaluation of periodontal parameters like the remaining number of teeth, bleeding on probing periodontal probing depth, and periodontal inflamed surface area (PISA). The degree of fibrosis in each LAA was quantified by Azan–Mallory staining.
Results:
- Atrial fibrosis was positively correlated with bleeding on probing, periodontal probing depth of ≥4 mm, and PISA.
- PISA was positively and strongly correlated with atrial fibrosis among patients with >10 remaining teeth.
- After adjustments for age, AF duration, BMI, mitral valve regurgitation, and CHADS₂ (congestive heart failure, hypertension, age, diabetes, previous stroke/transient ischemic attack) score, PISA was significantly associated with atrial fibrosis.
Thus, periodontitis and atrial fibrosis were histologically linked, and periodontitis is also a risk factor for AF.
Further reading: Miyauchi S, Nishi H, Ouhara K, et al. Relationship Between Periodontitis and Atrial Fibrosis in Atrial Fibrillation. J Am Coll Cardiol EP. null2022, 0 (0). https://doi.org/10.1016/j.jacep.2022.08.018
BDS, MDS
Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751