Abstract
Background The aim of this pilot study was to detect correlations of microbiological DNA, inflammatory
proteins, and infection parameters in patients with periodontal disease (PD) and valvular
heart disease (VHD).
Methods A perioperative comprehensive dental examination for the investigation of periodontal
status, including sampling of specific subgingival bacteria, was performed in 10 patients
with indication for surgery of aortic valve stenosis with or without concomitant myocardial
revascularization. Standard protocol biopsies were taken from right atrium (A), left
septal myocardium (M), and aortic valve (V). Eleven periodontal pathogens DNA in oral
and cardiac tissue samples (A/M/V) were analyzed using polymerase chain reaction.
For cardiac tissue samples, Western blot analysis of LPS-binding protein (LBP), immunohistochemical
(IHC) detection of LBP-big42, LPS-binding protein receptor (CD14), and macrophages
(CD68), as well as inflammation scoring measurement were performed.
Results Periodontitis was present in all patients with severe intensity in 7, moderate in
2 and mild in one patient. Same bacterial DNA was detected in A, M, and V in different
distribution, and detection was more often in atrium than in myocardium or valve tissue.
Morphological investigation revealed increased extracellular inflammatory cell migration.
In IHC markers of LBP, CD68 and CD14 showed positive findings for all patients in
atrium and myocardium.
Conclusion Our results demonstrate the presence of oral bacterial DNA in human cardiac tissue,
as well as inflammatory markers potentially indicating connection of PD and VHD. Further
investigation is necessary to confirm these preliminary data.
Keywords
heart valve surgery - systemic inflammation - microbiology - periodontal disease
