Journal of Rare Cardiovascular Diseases

Background: Pulmonary arterial hypertension (PAH) isa progressive disease characterized by vascular remodeling and sustainedinflammation. Key inflammatory mediators like C-reactive protein (CRP),interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-\(\alpha\)) are implicated in itspathogenesis and prognosis. Periodontal disease (PD), a chronicinflammatory condition of the oral cavity, is a known contributor tosystemic inflammatory burden. While the link between PD and systemiccardiovascular diseases is well-established, its specific relationshipwith the inflammatory milieu of PAH is poorly understood.Aim: This study aimed to investigate the correlationbetween periodontal disease activity and the levels of key seruminflammatory markers in a cohort of patients with stable PAH.Methodology: We conducted a cross-sectional studyinvolving 68 adult patients with a confirmed diagnosis of PAH (WHO Group1). Participants underwent a comprehensive periodontal examination toassess Probing Depth (PD), Clinical Attachment Loss (CAL), and Bleedingon Probing (BOP). Based on the 2017 World Workshop classificationcriteria, they were categorized into two groups: Active PD (n=32) andNo/Stable PD (n=36). Venous blood samples were collected to measureserum concentrations of high-sensitivity C-reactive protein (hs-CRP),IL-6, and TNF-\(\alpha\) usingenzyme-linked immunosorbent assays (ELISA). PAH severity was assessedusing WHO Functional Class and 6-minute walk distance (6MWD).Key Results: Patients in the Active PD group hadsignificantly higher median serum concentrations of hs-CRP (4.1 mg/L vs.1.8 mg/L; p\(<\)0.001), IL-6 (5.2pg/mL vs. 2.5 pg/mL; p=0.002), and TNF-\(\alpha\) (3.9 pg/mL vs. 2.1 pg/mL; p\(<\)0.001) compared to the No/Stable PDgroup. The percentage of sites with BOP, an indicator of activeperiodontal inflammation, showed a significant positive correlation withhs-CRP (r=0.58, p\(<\)0.001), IL-6(r=0.45, p=0.002), and TNF-\(\alpha\)(r=0.51, p\(<\)0.001). Theseassociations remained significant after adjusting for age, sex, and PAHseverity. Conclusions: In patients with PAH, activeperiodontal disease is strongly associated with elevated levels ofsystemic inflammatory markers. These findings suggest that periodontalinflammation may contribute to the systemic inflammatory milieu in PAH.Further longitudinal research is warranted to determine if periodontaltherapy can mitigate systemic inflammation and impact clinical outcomesin this vulnerable population.