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Biomolecules. 2018 Aug 1;8(3). pii: E66. doi: 10.3390/biom8030066.

Potential Impact of Oral Inflammations on Cardiac Functions and Atrial Fibrillation.

Author information

1
Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. g.aarabi@uke.de.
2
Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, 20251 Hamburg, Germany. r.schnabel@uke.de.
3
DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/L├╝beck, 20251 Hamburg, Germany. r.schnabel@uke.de.
4
Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. g.heydecke@uke.d.
5
Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. u.seedorf@uke.de.

Abstract

Inflammation may be a risk factor for atrial fibrillation (AF). Oral infections frequently lead to chronic inflammation, such as gingivitis, periodontitis, and endodontic lesions. In this narrative review, we consider five basic pathogenic mechanisms that involve oral infections and inflammations in the pathogenesis of AF: (1) low level bacteremia by which oral bacteria enter the blood stream at inflamed sites of the oral cavity and invade the heart; (2) Systemic inflammation induced by inflammatory mediators, which are released from the sites of oral inflammation into the blood stream, affecting cardiac remodeling; (3) autoimmunity against molecular structures expressed in the heart caused by the host immune response to specific components of oral pathogens; (4) potentially arrhythmic effects mediated by activation of the autonomous nervous system triggered by oral inflammations; and (5) arrhythmic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. A number of studies support the involvement of all five mechanisms, suggesting a potentially complex contribution of oral inflammations to the pathogenesis of AF.

KEYWORDS:

atrial fibrillation; autoimmunity; autonomous nervous system; bacteremia; bacterial toxins; oral health

PMID:
30071583
PMCID:
PMC6164509
DOI:
10.3390/biom8030066
[Indexed for MEDLINE]
Free PMC Article

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