{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:50:33Z","timestamp":1788889833282,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,11]],"date-time":"2019-01-11T00:00:00Z","timestamp":1547164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003803","name":"University of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Periodontal Research"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Subjects with diabetes and periodontitis are at high risk of cardiovascular events, while the subclinical alterations of cardiac function in this cohort remain unclear. This cross\u2010sectional study investigated the association of periodontitis with left ventricle (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) structural and functional abnormalities in subjects with type 2 diabetes mellitus (T2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A total of 115 subjects with T2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> were divided into Control group (n\u00a0=\u00a032) with no or mild periodontitis, and the rest with moderate to severe chronic periodontitis (<jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>) were further categorized into <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\u20101 (n\u00a0=\u00a041) and <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\u20102 (n\u00a0=\u00a042) based on disease severity. Echocardiography was performed to precisely assess (a) <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> hypertrophy by <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> mass index (<jats:styled-content style=\"fixed-case\">LVM<\/jats:styled-content>i); (b) <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> diastolic function by tissue Doppler imaging index E\/e\u2019 ratio; and (c) <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> systolic function by speckle tracking derived global longitudinal strain (<jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, a linear trend in <jats:styled-content style=\"fixed-case\">LVM<\/jats:styled-content>i, E\/e\u2019, and <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content> existed among the Control, <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\u20101, and <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\u20102 groups, respectively (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). After adjustments of multiple confounders, <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\u20102 subjects showed significantly higher E\/e\u2019 (log scale, 2.22\u00a0\u00b1\u00a00.05 vs 2.07\u00a0\u00b1\u00a00.06, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01) and <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content> (\u221217.42\u00a0\u00b1\u00a00.46% vs \u221218.95\u00a0\u00b1\u00a00.54%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05) than the Controls. Multivariate analysis revealed that sites% with probing depth \u22654\u00a0mm and sites% with clinical attachment loss \u22655\u00a0mm were independent indicators for E\/e\u2019 (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.005 and <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.002, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01) and <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content> (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.03 and <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.02, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05) , respectively. Moreover, the number of missing teeth was significantly associated with <jats:styled-content style=\"fixed-case\">LVM<\/jats:styled-content>i (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.01, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides the first evidence that severe periodontitis is significantly associated with the exacerbation of <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> diastolic and systolic dysfunction in subjects with T2DM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jre.12634","type":"journal-article","created":{"date-parts":[[2019,1,12]],"date-time":"2019-01-12T06:38:07Z","timestamp":1547275087000},"page":"339-348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Periodontitis links to exacerbation of myocardial dysfunction in subjects with type 2 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