Background. Periodontitis is a chronic inflammatory disease and might be a potential risk factor for ischemic heart disease (IHD). However, the link between periodontitis and atherosclerosis is not yet fully understood. Paraoxonase-1 (PON-1) is a new biomarker representing both anti-atherosclerotic and antioxidant activity, which also acts against dental biofilm formation and periodontitis. The possible contributing role of PON-1 in the relationship between periodontitis and atherosclerosis has not been studied to date. Objectives.The aim of the present study was to investigate the serum level of PON-1 with regard to the periodontal status in IHD patients. Material and methods.In this case-control study, 67 patients with IHD underwent a periodontal examination and were accordingly allocated to one of the 2 study groups: the case group with chronic periodontitis (n = 36); or the control group with a healthy periodontium (n = 31). Serum PON-1 activity was measured by means of colorimetric analysis.Results. There were no significant differences between the groups in terms of demographic data, cardiac risk factors, initial biochemical test results, cardiac pump function, and the number of grafted vessels. The activity of PON-1 in cardiac patients suffering from periodontitis was significantly lower than in cardiac patients with a healthy periodontal status (53.01 ±7.53 U/mL and 59.11 ±9.95 U/mL, respectively; p = 0.007).Conclusions. This finding suggests that the combination of IHD and periodontitis is associated with lower PON-1 activity. Further studies might be required to assess the possible role of periodontal treatment in increasing PON-1 activity and reducing IHD severity.
Background: Ventricular Septal Rupture (VSR) is a rare but challenging complication after myocardial infarction (MI). In the presence of acute MI, volume and pressure overload lead to acute heart decompensation. The present study was designed to evaluate the early surgical outcome of VSR for over 18 years. Method: This multicenter study was done during 2000-2018, in which 99 patients with post-MI VSR were included. Results: The patients (n=11) presenting hemodynamic deterioration at the time of hospital admission, died before any attempt for surgery. A consecutive series of 88 patients with surgical repair of VSR was evaluated. The mean interval from MI to VSR diagnosis was 7.5±7.2 days and from admission to the operation was 5±5 days. VSR location did not influence the outcome (p=0.1). The concomitant coronary bypass was done for all patients; two-vessel disease was more prevalent (39%). Only 25 patients survived and left the hospital (13 patients died in the operating room due to the failure of pump weaning and 50 patients in the ICU due to low cardiac output). Predictors of poor prognosis included low ejection fraction (p=0.01), prolonged pump time (p=0.01), and operation in the second half of this period (p=002). Conclusion: Despite the improvement in perioperative management and cardiac surgery techniques, the perioperative mortality rate of VSR has remained high where the assist device is not accessible. We suggest VSR repair limited to certain centers with adequate experiences because of the low average annual number.
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