Elastic Properties of the Aorta Are Affected in Young Patients with Sleep Bruxism

Document Type : Original Article

Authors

1 Department of Cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey

2 Department of Cardiology, Sincan State Hospital, Ankara, Turkey

3 Department of Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey

Abstract

Background and aim: This study aimed to evaluate the effects of sleep bruxism (SB) on aortic elastic properties, which predict cardiovascular morbidity and mortality.
Materials and methods: Twenty-eight patients (25 female, 3 male) with SB admitted to maxillofacial surgery outpatient clinic were enrolled in the study. The control group consisted of age and sex-matched 44 volunteers (9 female, 5 male) with no Bruxism complaints and normal orofacial examination findings. The two groups were compared in terms of aortic stiffness as measured by pulse wave velocity (PWV), aortic strain, and aortic distensibility.
Results: Aortic strain and aortic distensibility were statistically significantly decreased in SB patients compared to the control group (p=0,006 and p=0,028 respectively), while PWV was increased in SB patients compared to the control group with a limited statistical significance (p=0.064). Correlation analysis revealed statistically significant positive associations between PWV and CRP level (r=0.281, p=0.017) and negative associations between aortic strain and distensibility with CRP level (r=-0.347, p=0.003 and r=-0.277, p=0.019, respectively). The diastolic function parameters, E/A, E/é mean, and E wave deceleration time, were within normal limits in SB patients, and we did not observe statistically significant differences among diastolic function parameters between two groups.
Conclusion: Our study illustrated that aortic strain and aortic distensibility were decreased while PWV was increased in patients with SB. Further studies are required to further elucidate cardiovascular system manifestations in SB patients.

Keywords

Main Subjects

References

[1] Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain. 2013;27(2):99-110. doi:10.11607/jop.921.
[2] Pingitore G, Chrobak V, Petrie J. The social and psychologic factors of bruxism. The Journal of prosthetic dentistry. 1991;65(3):443-6. https://doi.org/10.1016/0022-3913(91)90240-W.
[3] Huynh N, Kato T, Rompre PH, Okura K, Saber M, Lanfranchi PA, et al. Sleep bruxism is associated to micro‐arousals and an increase in cardiac sympathetic activity. Journal of sleep research. 2006;15(3):339-46. https://doi.org/10.1111/j.1365-2869.2006.00536.x.
[4] Nashed A, Lanfranchi P, Rompré P, Carra MC, Mayer P, Colombo R, et al. Sleep bruxism is associated with a rise in arterial blood pressure. Sleep. 2012;35(4):529-36. https://doi.org/10.5665/sleep.1740.
[5] Seraidarian P, Seraidarian PI, das Neves Cavalcanti B, Marchini L, Neves AC. Urinary levels of catecholamines among individuals with and without sleep bruxism. Sleep and Breathing. 2009;13(1):85-8. https://doi.org/10.1007/s11325-008-0193-7.
[6] Marthol H, Reich S, Jacke J, Lechner KH, Wichmann M, Hilz MJ. Enhanced sympathetic cardiac modulation in bruxism patients. Clinical Autonomic Research. 2006;16(4):276-80. https://doi.org/10.1007/s10286-006-0355-2.
[7] Holwerda SW, Luehrs RE, DuBose L, Collins MT, Wooldridge NA, Stroud AK, et al. Elevated muscle sympathetic nerve activity contributes to central artery stiffness in young and middle-age/older adults. Hypertension. 2019;73(5):1025-35. https://doi.org/10.1161/HYPERTENSIONAHA.118.12462.
[8] Redheuil A, Yu WC, Wu CO, Mousseaux E, De Cesare A, Yan R, et al. Reduced ascending aortic strain and distensibility: earliest manifestations of vascular aging in humans. Hypertension. 2010;55(2):319-26. https://doi.org/10.1161/HYPERTENSIONAHA.109.141275.
[9] Tomiyama H, Matsumoto C, Shiina K, Yamashina A. Brachial-ankle PWV: current status and future directions as a useful marker in the management of cardiovascular disease and/or cardiovascular risk factors. Journal of atherosclerosis and thrombosis. 2015;23(2):32979. https://doi.org/10.5551/jat.32979.
[10] Laurent S. European Network for Non-invasive Investigation of Large Arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588-605.
[11] Lancellotti P, Zamorano JL, Habib G, Badano L, editors. The EACVI textbook of echocardiography. Oxford University Press; 2016 Nov 18.
[12] Styczynski G, Rdzanek A, Pietrasik A, Kochman J, Huczek Z, Sobieraj P, et al. Echocardiographic assessment of aortic pulse-wave velocity: validation against invasive pressure measurements. Journal of the American Society of Echocardiography. 2016;29(11):1109-16. https://doi.org/10.1016/j.echo.2016.07.013.
[13] Redheuil A, Wu CO, Kachenoura N, Ohyama Y, Yan RT, Bertoni AG, et al. Proximal aortic distensibility is an independent predictor of all-cause mortality and incident CV events: the MESA study. Journal of the American College of Cardiology. 2014;64(24):2619-29. http://dx.doi.org/10.1016/j.jacc.2014.09.060.
[14] Grodzki C. Stress effects on arterial blood pressure and heart rate depending on presence of bruxism. Protetyka stomatologiczna. 1978;28(3):180.
[15] Kara MI, Yanık S, Keskinruzgar A, Taysi S, Copoglu S, Orkmez M, et al. Oxidative imbalance and anxiety in patients with sleep bruxism. Oral surgery, oral medicine, oral pathology and oral radiology. 2012;114(5):604-9. https://doi.org/10.1016/j.oooo.2012.05.010.
[16] Michalek-Zrabkowska M, Wieckiewicz M, Smardz J, Gac P, Poreba R, Wojakowska A, et al. Determination of inflammatory markers, hormonal disturbances, and sleepiness associated with sleep bruxism among adults. Nature and Science of Sleep. 2020;12:969-979. doi: 10.2147/NSS.S268470.
[17] Keskinruzgar A, Kalenderoglu A, Yapici Yavuz G, Koparal M, Simsek A, Karadag AS, et al. Investigation of neurodegenerative and inflammatory processes in sleep bruxism. CRANIO®. 2020;38(6):358-64. https://doi.org/10.1080/08869634.2018.1543829.
[18] Schames SE, Schames J, Schames M, Chagall-Gungur SS. Sleep bruxism, an autonomic self-regulating response by triggering the trigeminal cardiac reflex. Journal of the California Dental Association. 2012;40(8):670-1.
[19] Park S, Lakatta EG. Role of inflammation in the pathogenesis of arterial stiffness. Yonsei medical journal. 2012;53(2):258-61. DOI: https://doi.org/10.3349/ymj.2012.53.2.258.
[20] Patel RS, Al Mheid I, Morris AA, Ahmed Y, Kavtaradze N, Ali S, et al. Oxidative stress is associated with impaired arterial elasticity. Atherosclerosis. 2011;218(1):90-5. https://doi.org/10.1016/j.atherosclerosis.2011.04.033.
[21] McEniery CM, Spratt M, Munnery M, Yarnell J, Lowe GD, Rumley A, et al. An analysis of prospective risk factors for aortic stiffness in men: 20-year follow-up from the Caerphilly prospective study. Hypertension. 2010;56(1):36-43. https://doi.org/10.1161/HYPERTENSIONAHA.110.150896.
[22] Wieckiewicz M, Paradowska-Stolarz A, Wieckiewicz W. Psychology aspect of bruxism, the most paramount factor influencing teeth grinding. BioMed Research International.;2014. doi: 10.1155/2014/469187.
[23] Cortez-Cooper MY, DeVan AE, Anton MM, Farrar RP, Beckwith KA, Todd JS, et al. Effects of high intensity resistance training on arterial stiffness and wave reflection in women. American journal of hypertension. 2005;18(7):930-4. https://doi.org/10.1016/j.amjhyper.2005.01.008.
[24] O’Rourke MF, Staessen JA, Vlachopoulos C, Duprez D. Clinical applications of arterial stiffness; definitions and reference values. American journal of hypertension. 2002;15(5):426-44. https://doi.org/10.1016/S0895-7061(01)02319-6.
[25] Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation. 2005;111(25):3384-90. https://doi.org/10.1161/CIRCULATIONAHA.104.483628.
[26] Laurent S, Katsahian S, Fassot C, Tropeano AI, Gautier I, Laloux B, et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke. 2003;34(5):1203-6. https://doi.org/10.1161/01.STR.0000065428.03209.64.
[27] Atilgan Z, Buyukkaya R, Yaman F, Tekbas G, Atilgan S, Gunay A, et al. Bruxism: is it a new sign of the cardiovascular diseases. Eur Rev Med Pharmacol Sci. 2011;15(12):1369-74.
[28] Abhayaratna WP, Marwick TH, Smith WT, Becker NG. Characteristics of left ventricular diastolic dysfunction in the community: an echocardiographic survey. Heart. 2006;92(9):1259-64. http://dx.doi.org/10.1136/hrt.2005.080150.
[29] McEniery CM, Yasmin N, Hall IR, Qasem A, Wilkinson IB, Cockcroft JR. Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). Journal of the American College of Cardiology. 2005;46(9):1753-60. doi:10.1016/j.jacc.2005.07.037.
 [30] Roman MJ, Ganau A, Saba PS, Pini R, Pickering TG, Devereux RB. Impact of arterial stiffening on left ventricular structure. Hypertension. 2000;36(4):489-94. https://doi.org/10.1161/01.HYP.36.4.489.
 [31] Leite-Moreira AF, Correia-Pinto J, Gillebert TC. Afterload induced changes in myocardial relaxation: a mechanism for diastolic dysfunction. Cardiovascular research. 1999;43(2):344-53. https://doi.org/10.1016/S0008-6363(99)00099-1.
[32] Ahmad SS, Gerson MC. Sympathetic drive stimulating diastolic dysfunction? J Nucl Cardiol. 2018;25(4):1110-1113. doi: 10.1007/s12350-017-0809-z.
[33] Komnenov D, Levanovich PE, Perecki N, Chung CS, Rossi NF. Aortic Stiffness and Diastolic Dysfunction in Sprague Dawley Rats Consuming Short-Term Fructose Plus High Salt Diet. Integrated Blood Pressure Control. 2020;13:111-124. doi: 10.2147/IBPC.S257205.
International Journal of Scientific Research in Dental and Medical Sciences
Volume 3, Issue 4
December 2021
Pages 171-178

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History

  • Receive Date: 21 October 2021
  • Revise Date: 28 November 2021
  • Accept Date: 08 December 2021

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