Carrizales-Sepúlveda Edgar Francisco, Ordaz-Farías Alejandro, Vera-Pineda Raymundo, Flores-Ramírez Ramiro
Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Echocardiography Laboratory, Cardiology Service, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Heart Lung Circ. 2018 Nov;27(11):1327-1334. doi: 10.1016/j.hlc.2018.05.102. Epub 2018 Jun 2.
Periodontal and cardiovascular disease are both major health issues. Poor oral health has long been associated with the development of systemic diseases, with the typical example being the risk of endocarditis posterior to dental procedures. Through the years, the association of periodontal disease with other non-infectious systemic diseases has been brought to attention. One of the most interesting associations is the one that exists with the development of cardiovascular disease. Many studies, including systematic reviews and meta-analyses, suggest an important association between periodontal disease and ischaemic heart disease, cerebrovascular disease, heart failure, atrial fibrillation and peripheral artery disease. Among the proposed mechanisms of this relationship, systemic inflammation appears to play a major role. Evidence suggests that periodontal inflammation triggers a systemic inflammatory state that, added to the damage mediated by antibodies that cross react between periodontal pathogens and components of the intimal wall, and the direct lesion of the intima by bacteria entering the circulation, promotes atheroma plaque development and progression. There are other studies that show a clear relationship between periodontal disease severity, elevations of inflammatory markers, and the presence of atherosclerosis. Here, we give a review of the available evidence supporting this association, and the possible mechanisms involved.
牙周病和心血管疾病都是主要的健康问题。长期以来，口腔健康状况不佳一直与全身性疾病的发生有关，典型的例子是牙科手术后发生心内膜炎的风险。多年来，牙周病与其他非传染性全身性疾病之间的关联已引起关注。最有趣的关联之一是与心血管疾病的发生之间的关联。许多研究，包括系统评价和荟萃分析，表明牙周病与缺血性心脏病、脑血管疾病、心力衰竭、心房颤动和外周动脉疾病之间存在重要关联。在这种关系的多种潜在机制中，全身炎症似乎起着主要作用。有证据表明，牙周炎症引发全身炎症状态，再加上牙周病原体与内膜壁成分之间交叉反应的抗体介导的损伤，以及细菌进入循环系统对内膜的直接损害，促进了动脉粥样硬化斑块的形成和发展。还有其他研究表明牙周病严重程度、炎症标志物升高与动脉粥样硬化的存在之间存在明显关系。在此，我们对支持这种关联的现有证据以及可能涉及的机制进行综述。
