Detection of Periodontal Pathogens in Oral Samples and Cardiac Specimens in Patients Undergoing Aortic Valve Replacement: A Pilot Study.

Alessia Pardo,Cecilia Rossetti,Elena Messina,Nunzio Davide De Manna,Maria Carelli,Maddalena Tessari,Massimo Albanese,Giovanni Battista Luciani,Caterina Signoretto,Annarita Signoriello,Giorgio Lombardo

doi:10.3390/jcm10173874

Abstract

This observational study aimed to: (i) assess the presence of periodontal disease among patients requiring aortic valve replacement; (ii) investigate the presence of oral pathogens in aortic valve specimens and compare them with the microorganisms detected in the oral cavity. Twenty-six patients (15 men and 11 women) were scheduled to be visited the day before the cardiac surgery: periodontal conditions were accurately registered through clinical and radiographic examinations; dental plaque or salivary samples were collected. Valve specimens were collected during surgical aortic valve replacement and analyzed for pathogens detection through microbiological 16SrRna gene sequencing. Bacteria found in plaque samples and valve specimens were assessed according to oral and periodontal conditions. A qualitative comparison between oral and cardiac profiles of the microorganisms detected was performed. The overall number of patients examined for soft tissues conditions was 19, as 7 patients were edentulous. Twelve and three individuals, respectively, presented moderate and severe periodontitis. Nine valves were found to be positive for the presence of oral and periodontopathic bacterial DNA. The microbial species found in valve samples of patients with periodontitis suggest that the presence of these microorganisms in valvular tissue seems to be not coincidental.

Highlights

The most common dental diseases connected with the presence of oral bacterial species are caries, pulp diseases and periodontitis [1,2]
From a clinical point of view, this result suggests that oral bacteria found in aortic valve samples, associated or not with periodontal disease, may have a direct or indirect role in the development of cardiovascular disease
No periodontal pathogenic microorganisms belonging to the red complex were detected in aortic valve specimens of this study

Summary

Introduction

The most common dental diseases connected with the presence of oral bacterial species are caries, pulp diseases and periodontitis [1,2]. Recent studies [3] suggested a strong link between infections caused by oral pathogens and several systemic diseases, detailed responsible mechanisms are still not understood [2]. The following hypothetic pathways have been detected to describe the connections between oral infections and secondary systemic effects [5,6]: . The oral bacteria or their toxins dissemination from the oral cavity into the bloodstream circulation, as a consequence of a transient or prolonged bacteremia (direct injury); The inflammation markers and the innate immunity system reaction to the presence of oral microorganisms, which can cause indirectly heart tissue damages (indirect systemic effect). The association between periodontitis and cardiovascular diseases has been deeply investigated to identify possible etiological factors in common [2,8,9,10]

Methods

Discussion

Conclusion