{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:27:00Z","timestamp":1789496820587,"version":"build-2803163510"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2025,5,27]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      Recent studies have indicated an association between periodontitis and atrial fibrillation (AF), although the underlying mechanisms remain unclear.\n                      <jats:italic toggle=\"yes\">Porphyromonas gingivalis (P ginigivalis<\/jats:italic>\n                      ) is a causative agent of periodontal disease and is highly pathogenic. This study focused on\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      and aimed to investigate the relationship among periodontitis, atrial translocation of\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      , and atrial fibrosis and AF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      An experiment was conducted using\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      \u2013infected C57BL\/6J mice, in which\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      was inoculated into the pulp of the molars. Immunohistochemistry was used to visualize the localization of\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      , and loop-mediated isothermal amplification was employed to detect\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      DNA in the left atrium. AF inducibility was examined by intracardiac stimulation. Moreover, left atrial appendage specimens were obtained from 68 patients with AF. A periodontal examination was conducted before the surgery, and the periodontal epithelial surface area and periodontal inflamed surface area, which are quantitative indices used to determine the clinical severity of periodontitis, were measured. The bacterial number of\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      in human atrial tissue was analyzed via quantitative polymerase chain reaction. Atrial fibrosis was assessed using Azan-Mallory staining.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The translocation path of\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      from the dental granuloma to the left atrium via the circulatory system was demonstrated by immunohistochemistry and loop-mediated isothermal amplification in\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      \u2013infected mice, which showed a higher degree of atrial fibrosis (21.9% versus 16.3%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.0003) and a higher AF inducibility (30.0% versus 5.0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.04) than the control mice. Upregulation of galectin-3 and transforming growth factor-beta 1 in the left atrium was observed in\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      \u2013infected mice. Moreover, immunohistochemistry revealed that\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      was also present in human atrial tissue. The number of\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      in the human atrial tissue was positively correlated with periodontal epithelial surface area (\u03c1=0.35;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.004), periodontal inflamed surface area (\u03c1=0.52,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001), and the degree of atrial fibrosis (\u03c1=0.38;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      translocation to the left atrium correlates with the clinical severity of periodontitis, which may exacerbate atrial fibrosis and AF. Atrial translocation of\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:italic toggle=\"yes\">gingivalis<\/jats:italic>\n                      is a potential pathway explaining the causal relationship between periodontitis and AF.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.124.071310","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T05:01:07Z","timestamp":1742274067000},"page":"1527-1540","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Atrial Translocation of\n                    <i>Porphyromonas gingivalis<\/i>\n                    Exacerbates Atrial Fibrosis and Atrial Fibrillation"],"prefix":"10.1161","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5781-3182","authenticated-orcid":true,"given":"Shunsuke","family":"Miyauchi","sequence":"first","affiliation":[{"name":"Departments of Cardiovascular Medicine (S.M., N.O., T. 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