Objective: Periodontitis is common as well as cardiac disease. Coincidental or casual correlation
of these diseases is a pivotal question. In an experimental setting we evaluated methods
to detect correlations of periodontal disease and effect on cardiac tissue.
Methods: Out of 10 patients with more than 6 teeth a complete dental and periodontal status
with oral microbiological testing and removal of tissue specimen while cardiac operation
(left ventricle, right atrium and aortic valve) was performed. The detection of 11
periodontal pathogens in the oral and heart samples was carried out with PCR. The
heart samples were prepared for detecting LPS-binding protein (Western Blot), sections
of tissue for inflammation scoring by H&E staining (score 0-3), and for determining
immunohistochemical parameters: macrophages (CD68), LPS-binding protein (big42) and
LPS-binding protein-receptor (CD14).
Results: All 10 patients had aortic valve disease and 5 had concomitant coronary heart disease.
6 were male and mean age was 69 years. Periodontitis was severe in 7, moderate in
2 and mild in 1 patient. Finding of microbial DNA was high (>70%) in oral periodontal
specimen and decreased in cardiac tissue (atrium of 10-40%; in ventricle 10-20% and
valve 0-20%). IHC revealed high inflammation scores in all cardiac tissue specimens,
and big42, CD14 and CD68 immuno-staining showed higher scores in atrial tissue than
in ventricle.
Conclusions: IHC, western-blot and DNA-PCR findings showed a relationship and occurrence of periodontal
microbial affection in cardiac tissue with subsequent immunoreaction by high LPS reaction
and macrophage infiltration. We suspect a casual correlation of periodontal and cardiac
disease, and further investigations are initiated to verify this hypothesis.
