2024 Volume 44 Issue 4 Pages 221-230
Intervention to the modifiable risk factors is important in the comprehensive management of atrial fibrillation（AF）. Although periodontitis is highly prevalent and can be modified by dental intervention, it has not been recognized as a risk factor for AF. This study aimed to investigate the relationship between periodontitis and atrial fibrosis which is known as an AF substrate. Seventy-six patients with AF who underwent left atrial appendage（LAA）resection during surgery were included. LAA patients received a periodontal examination before the surgery in which periodontal inflamed surface area（PISA）was measured as a quantitative index of periodontitis. The degree of atrial fibrosis was histologically quantified using the LAA. We found that PISA was positively correlated with the degree of atrial fibrosis（R＝0.46 ; P＜0.0001）. After adjusting for age, body mass index, AF duration, mitral valve regurgitation, and CHADS2（congestive heart failure, hypertension, age, diabetes, previous stroke/transient ischemic attack）score, PISA was independently associated with the degree of atrial fibrosis（β＝0.016 ; P＝0.0002）. This study histologically revealed the association of periodontitis with atrial fibrosis in patients with AF. Periodontitis may worsen atrial fibrosis by eliciting systemic inflammation, which may be causative for AF occurrence and perpetuation. Further clinical and basic evidence will be required to confirm that periodontitis is a modifiable risk factor for AF, and the medical-dental cooperation in the comprehensive management of AF may be essential.
