Key result
Periodontitis is linked to a ~4-fold higher sympathetic nervous system index than gingivitis.
Why the study?
Periodontitis is a chronic inflammatory disease with systemic impacts, prompting investigation into how periodontal disease severity correlates with cardiac autonomic dysfunction assessed by heart rate variability.
Does periodontitis severity correlate with cardiac autonomic dysfunction as measured by Heart Rate Variability (HRV) analysis in patients with periodontal disease?
Cross-Sectional (n=54)
Does periodontitis severity correlate with cardiac autonomic dysfunction as measured by Heart Rate Variability (HRV) analysis in patients with periodontal disease?
Periodontitis is associated with altered cardiac autonomic regulation, evidenced by a higher sympathetic nervous system index and lower parasympathetic nervous system index compared to gingivitis.
Periodontitis may link to sympathetic predominance on HRV; hypothesis-generating for whether periodontal therapy improves autonomic balance or CV outcomes.
Introduction: Periodontitis is a chronic inflammatory disease damaging the supportive structure of teeth. It has systemic impacts including cardiac autonomic dysfunction. Heart Rate Variability (HRV) measures an objective analysis of the extent of autonomic regulation and where decreased parasympathetic activity coupled with increased sympathetic predominance was determined to correlate well with risk in cardiovascular events. This research ascertains periodontitis and its correlation to autonomic dysfunction by HRV analysis. Methodology: In total, 54 periodontitis patients were involved in the study, categorized under four groups, namely Gingivitis (n=14), Mild Periodontitis (n=13), Moderate Periodontitis (n=13), and Severe Periodontitis (n=14). Kubios HRV software version 3.5 was used for the analysis of time-domain and frequency-domain parameters of lead II ECG for HRV analysis. The indices of SNS and PNS were calculated for the assessment of autonomic balance. The correlation between the HRV parameters with the severity of periodontal disease was performed statistically. Results: The SNS index was higher in the periodontitis groups than in the gingivitis group (Gingivitis: 1.09 ± 0.60; Mild: 4.25 ± 2.4; Moderate: 3.82 ± 2.2; Severe: 4.45 ± 1.5; p < 0.001), although the pattern was not strictly progressive. Conclusion: Differences in autonomic regulation, including higher SNS index and lower PNS index values, were associated with periodontal disease categories. These findings should be interpreted cautiously because the study lacked a healthy control group and was cross-sectional.
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Vineetha et al. (2026) conducted a cross-sectional in Periodontitis (n=54). Periodontitis (mild, moderate, and severe) vs. Gingivitis was evaluated on Sympathetic Nervous System (SNS) index from Heart Rate Variability (HRV) analysis (p=<0.001). Periodontitis was associated with a higher SNS index than gingivitis (Gingivitis: 1.09 vs Mild: 4.25, Moderate: 3.82, Severe: 4.45; p<0.001).
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