A prospective histological cohort study in Japan revealed the association of periodontitis with atrial fibrosis. The study enrolled 76 patients with atrial fibrillation (AF, 55 with nonparoxysmal AF, 25 with mitral valve regurgitation, 18 with left atrial appendages [LAA] thrombus) who were scheduled to undergo LAA excision during cardiac surgery. The degree of fibrosis in each LAA was quantified by Azan–Mallory staining. Bleeding on probing (R = 0.48; P < 0.0001), periodontal probing depth of ≥4 mm (R = 0.26; P = 0.02), and periodontal inflamed surface area (PISA, R = 0.46; P < 0.0001) were positively correlated with atrial fibrosis. Among patients with >10 remaining teeth, PISA was positively and strongly correlated with atrial fibrosis (R = 0.57; P < 0.0001). After adjustments for age, AF duration, BMI, mitral valve regurgitation, and CHADS₂ (congestive heart failure, hypertension, age, diabetes, previous stroke/transient ischemic attack) score, PISA was significantly associated with atrial fibrosis (β = 0.016; P = 0.0002). The findings add to the mounting evidence linking periodontitis with systemic diseases, such as cardiovascular diseases, diabetes and rheumatoid arthritis. Source: https://www.jacc.org/
