Association between periodontal bacteria and degenerative aortic stenosis: a pilot study.
Association between periodontal bacteria and degenerative aortic stenosis: a pilot study.
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DOI：
10.5051/jpis.2006040302
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发表时间：
2021-08
影响因子：
1.9
通讯作者：
Kozuma K
中科院分区：
文献类型：
--
作者：
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
虽然一些报告已经描述了牙周病和心血管疾病之间的关系，牙周病和退行性主动脉瓣狭窄（AS）的进展之间的关联的信息是缺乏的。因此，我们进行了一项回顾性、单中心、初步研究，以深入了解这种潜在的关联。分析了45例轻度或中度退行性主动脉瓣狭窄连续患者（19例男性;中位年龄83岁）的数据，平均观察期为3.3±1.9年。检测两组患者血清中伴放线菌聚集菌和牙龈卟啉单胞菌总数、抗牙周细菌免疫球蛋白G（IgG）和超敏C反应蛋白（hs-CRP）水平。评价主动脉瓣面积（AVA）、最大血流速度（Vmax）、平均压差（平均PG）和多普勒血流速度指数（DVI）。根据回顾性随访超声心动图数据（基线与最近收集的数据[最新]）计算每年每个参数的变化（[ParameterLATEST-ParameterBASELINE]/随访年数）。唾液中牙周致病菌浓度与AS状态/进展之间无相关性。血清抗牙龈卟啉单胞菌抗体滴度与AVA、DVI呈显著正相关。抗牙龈卟啉单胞菌IgG抗体滴度与平均PG呈负相关，hs-CRP浓度与Vmax和平均PG呈正相关，抗牙龈卟啉单胞菌IgG抗体滴度与ΔAVA/year和Δmean PG/year呈负相关。hs-CRP浓度与Vmax和平均PG呈正相关，主动脉瓣狭窄进展迅速（ΔAVA/年<-0.1）的患者的hs-CRP浓度显著高于其对应者。我们的研究结果表明，牙周致病菌，如A。伴放线菌和牙龈卟啉单胞菌与退行性AS的状态/进展没有直接关系。然而，炎症和较低的免疫反应可能与疾病进展有关。
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. 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 ([ParameterLATEST–ParameterBASELINE]/Follow-up Years) was calculated from the retrospective follow-up echocardiographic data (baseline vs. the most recently collected data [latest]). 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. 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.