Abstract
ObjectivesThe aim of this cross-sectional study was to compare oral health-related quality of life (OHRQoL) of patients with left ventricular assist device (LVAD) and heart failure (HF).Material and methodsSeventy-four patients with LVAD were recruited from University Department for Cardiac Surgery, Leipzig Heart Center, Germany. A group of 72 patients with HF was composed by matching (age, gender, smoking). The German short form of oral health impact profile (OHIP G14) was applied. Health-related quality of life (HRQoL) was measured by short form 36 survey (SF-36). Dental conditions (decayed-, missing- and filled-teeth [DMF-T]), remaining teeth and periodontal findings were assessed. Statistics: t-test, Mann-Whitney U test, Kruskal-Wallis test, chi-square or Fisher test, linear regression.ResultsAge, gender, smoking, underlying disease, co-morbidities and oral findings were comparable between groups (p > 0.05). OHIP G14 sum score was 3.53 ± 6.82 (LVAD) and 2.92 ± 5.35 (HF; p = 0.70), respectively. The scales SF-36 physical functioning (p = 0.05) and SF-36 social functioning (p < 0.01) were worse in LVAD. In the LVAD group, the DMF-T and remaining teeth negatively correlated with OHIP G14 sum score (p < 0.01). In HF patients, positive correlations were found between OHIP G14 and D-T (p < 0.01) and remaining teeth (p = 0.04). Moreover, DMF-T (p = 0.03) and remaining molars/premolars (p = 0.02) were negatively correlated with SF-36 scales in HF.ConclusionsOral health and OHRQoL was comparable between LVAD and HF; thereby, OHRQoL reflected the clinical oral status.Clinical relevanceDental care, with beginning in early stage of HF, should be fostered to preserve teeth and support quality of life before and after LVAD implantation.
Highlights
For therapy of end-stage heart failure (HF), left ventricular assist devices (LVAD) are becoming increasingly relevant as a definitive substitute for heart transplant or as a bridge to transplantation [1, 2]
It has been reported that DNA of potentially periodontal pathogens, which are related to periodontal diseases, can be detectable in cardiac tissues [5]. This underlines the potential of these bacteria to cause infectious complications and supports the literature suggesting a relationship between periodontitis and coronary heart diseases [6, 7]
It was hypothesized that both groups show a comparable oral health-related quality of life (OHRQoL) that is not affected by oral conditions. This current study was designed as a cross-sectional examination to compare the OHRQoL and Health-related quality of life (HRQoL) of patients with LVAD and patients suffering from HF
Summary
For therapy of end-stage heart failure (HF), left ventricular assist devices (LVAD) are becoming increasingly relevant as a definitive substitute for heart transplant or as a bridge to transplantation [1, 2]. For these patients, oral health issues might be of particular importance. It has been reported that DNA of potentially periodontal pathogens, which are related to periodontal diseases, can be detectable in cardiac tissues [5]. This underlines the potential of these bacteria to cause infectious complications and supports the literature suggesting a relationship between periodontitis and coronary heart diseases [6, 7]. The only available previous study found a high prevalence of oral diseases, especially periodontal treatment need and a lack in oral behaviour of LVAD patients, without associations to driveline-related complications [9]
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