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Periodontal disease tied to risk of heart failure: Study

Written By : Dr. Kamal Kant Kohli Published On 2022-09-28T20:00:29+05:30  |  Updated On 28 Sept 2022 9:18 PM IST
Periodontal disease tied to risk of heart failure: Study
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USA: A study in the Journal of the American College of Cardiology reported that periodontal condition was connected to the development of HF, HFpEF, and HFrEF as well as adverse alterations in CRP and NT-proBNP.

Heart failure (HF) and its subtypes (heart failure with reduced ejection fraction [HFrEF] and heart failure with preserved ejection fraction [HFpEF]) have not been studied in relation to periodontal disease (PD), which results from an inflammatory host response to dysbiotic subgingival bacteria.

"Despite being a physiological defensive response meant to offer protection and encourage healing, inflammation can occasionally have the opposite effect. A person's risk of developing heart failure is increased by the direct effects that inflammatory cytokines have on myocardial cells," the authors wrote.

There is little proof that periodontal therapies prevent atherosclerotic cardiovascular disease or alter its outcomes, the researchers said, even though they lowered systemic inflammation and endothelial dysfunction in short-term studies.

According to the authors' hypothesis, having PD increases the likelihood of developing incident HF, HFpEF, and HFrEF.

The ARIC (Atherosclerosis Risk In Communities) study, included 6,707 participants (mean age 63 6 years) with full-mouth periodontal examination at visit 4 (1996-1998) and longitudinal follow-up for any incident HF (visit 4 to 2018), or incident HFpEF and HFrEF (2005-2018), was used to achieve this goal. According to the Periodontal Profile Classification [PPC], periodontal status was divided into three categories: healthy, PD, and edentulous. The link between PPC levels and incident HF, HFpEF, or HFrEF was estimated using multivariable-adjusted Cox proportional hazards models. Additionally, inflammatory and congested biomarkers like C-reactive protein (CRP) and N-terminal brain natriuretic peptide (NT-proBNP) were evaluated.

Key highlights of the study:

  • A total of 1,178 incident HF cases—350 HFpEF, 319 HFrEF, and 509 HF of uncertain type—occurred over a 13-year median period. 18% of these individuals were edentulous, while 59% of them had PD.
  • HFpEF was substantially more likely to occur in people with PD (HR: 1.69), and HFrEF was significantly more likely in people with PD (HR: 2.00) and edentulism (HR: 2.19).
  • While PD was related only with NT-proBNP, edentulism was associated with negative changes in both CRP and NT-proBNP.

The study's authors stated in their conclusion that given the high incidence of curable periodontal disease and the burden of heart failure in the aging society, population level consequences could be significant if subsequent research reveal causal relationship.

REFERENCE

Rebecca L. Molinsky, Melana Yuzefpolskaya, Faye L. Norby, Bing Yu, Amil M. Shah, James S. Pankow, Chiadi E. Ndumele, Pamela L. Lutsey, Panos N. Papapanou, James D. Beck, Paolo C. Colombo, Ryan T. Demmer, DOI:10.1016/j.jchf.2022.05.008, JACC: Heart Failure ( IF 12.544 ) Pub Date: 2022-07-06

C-reactive proteinheart failureN-terminal brain natriuretic peptideperiodontal diseaseJournal of the American College of Cardiologyatherosclerotic cardiovascular disease
Source : Journal of the American College of Cardiology
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

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

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