Dental infections might
predispose toward the onset of cardiovascular disease (CVD). To date,
only a few studies, yielding inconclusive findings, have investigated
the potential correlation between apical periodontitis (AP) and CVD. The
aim of this study (as the first part of a prospective study) was to
evaluate, in the absence of CV risk factors, whether subjects with AP
were more exposed to the pathogenetic indices of an atherosclerotic
Forty men between the ages of 20 and 40
years who were free from periodontal disease, CVD, and traditional CV
risk factors were enrolled in the study; 20 subjects had AP, and 20
acted as controls. All subjects underwent dental examination and
complete cardiac assessment: physical examination, electrocardiogram,
conventional and tissue Doppler echocardiography, and measurement of
endothelial flow reserve (EFR). The following laboratory parameters were
tested: interleukins -1, -2, and -6 (IL-1, IL-2, IL-6), tumor necrosis
factor alpha, and asymmetrical dimethylarginine (ADMA). Data were
analyzed by using the 2-tailed Student's t test, Pearson t test (or Spearman t test for nonparametric variables), and multivariate linear regression analysis.
Echocardiography revealed no abnormalities in any of the subjects studied. ADMA levels were inversely correlated with EFR (P < .05) and directly correlated with IL-2 (P < .001). Patients with AP presented with significantly greater blood concentrations of IL-1 (P < .05), IL-2 (P < .01), IL-6 (P < .05), and ADMA (P < .05) and a significant reduction of EFR (P < .05).
ADMA levels and their relationship with poor EFR and increased IL-2
might suggest the existence of an early endothelial dysfunction in young
adults with AP.