Plasmatic NT-proBNP concentrations in patients with coexistent periodontal disease and congestive heart failure: pilot studies

Abstract

The presented pilot study was conducted in order to evaluate dynamic fluctuations of blood inflammation markers among patients with congestive heart failure (CHF) and coexistent periodontitis (PD). The study hypothesis stated that elimination of chronic inflammation caused by PD has a significant impact on inflammation markers and, secondarily, also on the course and prognosis of CHF. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and tumour necrosis factor alpha (TNF-α) markers were assessed due to their proven diagnostic significance. Blood samples were collected at the time of CHF patients' admission to the clinical ward (I examination) and then after 3-9 months (average six months) after periodontal treatment completion (II examination). With antibiotic cover, basic periodontal parameters (such as CAL, PD, PI, BOP) were evaluated, scaling and root-planning were performed, and orthopantomogram X-rays were conducted. Patients received instructions about domestic oral hygiene procedures. Measurements were repeated during a second examination of blood samples. Obtained results were compared and statistically analysed. The initial outcome of the study confirmed the hypothesis that maintaining good and complex oral hygiene has an essential impact on blood concentration of NT-proBNP and TNF-α markers. Exploration of possibilities considering medical help and treatment optimisation seems to be evident also according to improvement of prognosis, therapy effectiveness, and patient comfort. Foregoing conclusions about biomarkers are, according to authors' best knowledge, the first such results reported in medical literature.