Objectives The aim of this study was to investigate the cross-sectional association between periodontal status and cardiac structural and functional status, with a focus on left ventricular (LV) geometry and function. The primary research question addressed whether indicators of periodontal disease are linked to markers of LV remodelling.

Materials and Methods Data were drawn from two population-based cohorts in the Study of Health in Pomerania (SHIP): SHIP-START-2 (n=2333) and SHIP-TREND-0 (n=4420). Periodontal status was assessed by bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), number of missing teeth, and the 2018 EFP/AAP classification. LV geometry (end-diastolic/systolic volume, mass, wall thickness) and function (ejection fraction, stroke volume, E/E’ ratio, left atrium diameter) were evaluated using echocardiography in confounder-adjusted regression analyses.

Results Mean PD, CAL, and number of missing teeth were positively associated with end-diastolic volume (PD: β=0.44; 95%CI: 0.13–0.74; CAL: β=0.21; 95%CI: 0.07–0.36; teeth: β=0.06; 95%CI: 0.03–0.09), end-systolic volume (PD: β=0.21; 95%CI: 0.05– 0.37; CAL: β=0.12; 95%CI: 0.05–0.20; teeth: β=0.03; 95%CI: 0.02–0.05), and LV mass (PD: β=1.31; 95%CI: 0.58–2.03; CAL: β=0.52; 95%CI: 0.18–0.86; teeth: β=0.17; 95%CI: 0.10–0.24). Values increased across periodontitis stages (p for trend <0.05). Stage IV was associated with reduced ejection fraction (β=−1.28; 95%CI: −2.45 to −0.12). Other functional markers showed no significant associations.

Conclusion Periodontitis is linked to cardiac remodelling, particularly increased LV volume and mass.

Clinical Relevance Findings support integrating periodontal health into cardiovascular risk management and highlight the need for further research.

The authors have declared no competing interest.

SHIP is part of the Community Medicine Research Network of the University Medicine Greifswald, which is supported by the German Federal State of Mecklenburg-West Pomerania. CP was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - 451892213.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Affiliations 1 Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Germany 2 Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany 3 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany 4 Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany 5 German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany 6 German Center for Diabetes Research (DZD), partner site Greifswald, Greifswald, Germany All SHIP studies were positively evaluated by the ethics committee of the University of Greifswald (SHIP-START-2: BB 39/08; SHIP-TREND-0: BB 39/08a). All participants were informed about the study protocol and signed the informed consent and the privacy statement.

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E-Mails: Maja Trost: majatrostfreenet.de, Till Ittermann: till.ittermannuni-greifswald.de, Birte Holtfreter: Birte.Holtfretermed.uni-greifswald.de, Christiane Pink: christiane.pinkuni-greifswald.de, Marcus Dörr: mdoerruni-greifswald.de, Henry Völzke: voelzkeuni-greifswald.de, Matthias Nauck: matthias.nauckmed.uni-greifswald.de, Marcello Ricardo Paulista Markus: marcello.markusuni-greifswald.de, Thomas Kocher: kocheruni-greifswald.de

The data that support the findings of this study are available from Forschungsverbund Community Medicine. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from https://transfer.ship-med.uni-greifswald.de/FAIRequest/login with the permission of Forschungsverbund Community Medicine.