Infectious and inflammatory diseases of the upper airways and atherosclerosis

The influence of a chronic infection site in the palatine tonsils on the cardiovascular system has been considered mainly in association with rheumatism. However, recognition of chronic periodontal infection as a standalone risk factor for atherosclerosis and its inclusion in international guidelines revealed a need to study the possible atherogenic effects of other infection sites. In the premises, chronic ENT infection is of interest, especially with a view to its prevalence in the population. Obesity, physical inactivity, smoking, etc. have been long considered as etiological factors of atherogenesis. However, atherosclerosis may develop even without typical risk factors. Over the past 20–30 years, a theory of atherogenic effect of infectious agents has been developed. The concept of a lifetime infectious burden has appeared, i.e. an adverse effect of chronic intoxication on the vascular wall, primarily the endothelium, accumulating from a young age, which is an important factor of atherosclerosis. The examined patients with chronic tonsillitis showed significantly higher rates of vascular stiffness compared to their peers without any infectious or inflammatory diseases. It has also been found that the incidence of myocardial disorders, including rhythm disorders (premature ventricular contractions), lower force of left ventricular contraction, and heart chamber remodeling (primarily a dilated left atrium), in patients with uncontrolled chronic tonsillitis is 3–4 times less than vascular disorders.