Pathogenetic justification of cardiovascular comorbidity in apical periodontitis in an experiment

Abstract

Introduction. Apical periodontitis is a common health problem associated with a deterioration in the overall condition of the body, especially in patients with type 2 diabetes (T2D) and cardiovascular diseases. Studies have shown that inflammatory processes in periodontitis can exacerbate systemic diseases, including heart conditions. However, the mechanisms behind this relationship remain poorly understood.

The methodology. The study used 48 male Wistar rats divided into 4 groups: control (normoglycemia without periodontitis), periodontitis (normoglycemia with periodontitis), DM2 (without periodontitis), and DM2+periodontitis. DM2 was modeled by a high-fat diet and streptozotocin injection. Periodontitis was induced by mechanical stimulation of the molar pulp. The heart function was assessed ex vivo using the Langendorff apparatus by measuring the following cardiodynamic parameters: dp/dt max, dp/dt min, systolic and diastolic pressure in the left ventricle (SLV, DLV), heart rate (HR), and coronary blood flow (CBF).

Results. The group of SD2+periodontitis showed a significant increase in dp/dt max and LVSD, a decrease in dp/dt min and HR compared to other groups. The greatest disturbances of coronary blood flow were observed in the combination of SD2 and periodontitis. Histopathological analysis revealed pronounced inflammatory and hypertrophic changes in the heart tissue in rats with SD2 and periodontitis.

Conclusion. Apical periodontitis exacerbates functional and structural heart disorders in rats with T2DM, which confirms the relationship between chronic oral inflammation and cardiovascular complications in diabetes. The results highlight the need for further research to develop cardioprotective strategies in patients with comorbid conditions.