CARATTERIZZAZIONE DEL MICROBIOTA ORALE E DI BIOPSIE DI TESSUTO VALVOLARE PATOLOGICO IN UN CAMPIONE DI PAZIENTI PARODONTALI E NON PARODONTALI

Aim. To assess the prevalence of periodontal disease among patients presenting severe heart valve impairment and requiring coronary by-pass surgery. To investigate the presence of periodontal pathogens in cardiovascular specimens and to analyse the relationship between oral and cardiovascular patterns of the microorganisms detected. Materials and Methods. An observational study was conducted at the Cardiovascular Surgery Division, University Hospital of Verona, Verona, Italy. The Ethical approval was previously obtained in order to enroll subjects referring to the Hospital for heart valves replacement and coronary bypass surgery. Patients were scheduled to be visited by a dentist, together with a dental hygienist, the day before the surgery: periodontal conditions were accurately registered through clinical and radiographic examinations and dental plaque or salivary samples were collected. Cardiovascular specimens were collected during surgical heart valve replacement for the scheduled microbiological 16 rRNA gene sequencing. Plaque samples and cardiovascular specimens were analyzed according to periodontal status. A qualitative comparison between oral and cardiovascular profiles of the microorganisms detected was also performed. Results. 26 patients (15 men and 11 women) attended the study. The overall number of patients examined for the conditions of soft tissues were 19, as 7 patients were edentulous and reported to had lost dentition for history of periodontal disease. 46.15% and 11.54% individuals respectively presented moderate periodontitis and severe periodontitis. A statistically significant difference (p=0.04) was found for PPD between healthy patients, patients with moderate periodontitis and patients with severe periodontitis. Regarding plaque samples and cardiovascular specimens, no statistically significant differences were found in both cases between healthy patients, patients with moderate periodontitis, patients with severe periodontitis and edentulous patients. Nine valves were found to be positive at the presence of oral and periodontophatic bacterial DNA. The principal species detected were Streptococcus periodonticum, Streptococcus mutans, Fusobacterium nucleatum-periodonticum, Aggregatibacter segnis and Porphyromonas pasteri. Conclusions. The significant number of oral and periodontopathic bacterial DNA species found in valve tissue samples, in patients with periodontitis, suggests that the presence of these microrganisms in valve tissue seems to be not coincidental, and that they may have a role in the development of vascular diseases.