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Research Article| Volume 264, P124-129, August 01, 2018

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Large animal model of acute right ventricular failure with functional tricuspid regurgitation

  • Author Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Marcin Malinowski
    Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave NE, Grand Rapids, MI 49503, USA

    Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Ziołowa 47, 40635 Katowice, Poland
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  • Author Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Alistair G. Proudfoot
    Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave NE, Grand Rapids, MI 49503, USA
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    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Lenora Eberhart
    Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
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    Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave NE, Grand Rapids, MI 49503, USA
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    Hans Schubert
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    Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave NE, Grand Rapids, MI 49503, USA
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    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Jeremy Wodarek
    Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
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    Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave NE, Grand Rapids, MI 49503, USA
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  • Author Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    David Langholz
    Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
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    Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave NE, Grand Rapids, MI 49503, USA
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    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Manuel K. Rausch
    Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Aerospace Engineering & Engineering Mechanics, Department of Biomedical Engineering, Institute for Computational Engineering and Science, University of Texas at Austin, 210 E 24th Street, Austin, TX 78703, USA
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  • Author Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Tomasz A. Timek
    Correspondence
    Corresponding author at: Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave SE, Grand Rapids, MI 49503, USA.
    Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Meijer Heart and Vascular Institute at Spectrum Health, 100 Michigan Ave NE, Grand Rapids, MI 49503, USA
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  • Author Footnotes
    1 These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
DOI:https://doi.org/10.1016/j.ijcard.2018.02.072
Large animal model of acute right ventricular failure with functional tricuspid regurgitation
Previous ArticleAngioedema in heart failure patients treated with sacubitril/valsartan (LCZ696) or enalapril in the PARADIGM-HF study
Next ArticleCirculating microRNAs as emerging cardiac biomarkers responsive to acute exercise

      Highlights

      • •
        Right heart failure model is created by volume, pulmonary hypertension and ischemia.
      • •
        Acute ovine right heart failure is accompanied by functional tricuspid regurgitation.
      • •
        Right ventricle is dilated and changes its equatorial strain pattern.
      • •
        Changes in ventricular geometry result in tricuspid annular enlargement.
      • •
        Acute right heart failure model created provides the novel research platform.

      Abstract

      Background

      Functional tricuspid regurgitation (FTR) commonly arises secondary to conditions affecting the left heart and is associated with right ventricular dysfunction and tricuspid annular dilatation. We set out to establish an animal model of acute RV failure (RVF) with FTR resembling the clinical features.

      Methods

      Ten adult sheep had pressure sensors placed in the LV, RV, and right atrium while sonomicrometry crystals were implanted around tricuspid annulus and on the RV. Animals were studied open-chest to assess for RV function and FTR after: (1) volume infusion, (2) pulmonary artery constriction, (3) 5 min posterior descending artery occlusion, and (4) combination of all interventions. Hemodynamic, echocardiographic, and sonomicrometry data were collected at baseline and after every intervention. RV dimensions, RV strain, and annular area, perimeter, and size were calculated from crystal coordinates. The model was validated in six additional sheep studied only before and after combined interventions.

      Results

      Neither volume infusion, pulmonary hypertension, nor ischemia were associated with RVF or clinically significant TR when applied separately but combined resulted in RVF and greater than moderate FTR. In the validation group, maximal RV volume increased (62 ± 14 vs 70 ± 16 ml, p = 0.006), contractility decreased (20 ± 6 vs 12 ± 2%, p = 0.02), and strain increased. FTR increased from 0.4 ± 0.5 to 2.5 ± 0.8 (p < 0.001) and annular area from 652 ± 87 mm2 to 739 ± 87 mm2 (p = 0.005).

      Conclusions

      The developed ovine model of acute RVF was associated with significant annular and RV enlargement and FTR. This novel and clinically pertinent research platform offers insight into the acute RVF pathophysiology and can be utilized to evaluate treatment interventions.

      Abbreviations:

      CPB (cardiopulmonary bypass), CVP (central venous pressure), EDP (end-diastolic pressure), FTR (functional tricuspid regurgitation), HR (heart rate), LV (left ventricle), PDA (posterior descending artery), PHT (pulmonary hypertension), RA (right atrium), RV (right ventricle), TR (tricuspid regurgitation)

      Keywords

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      Article info

      Publication history

      Accepted: February 19, 2018
      Received in revised form: February 12, 2018
      Received: January 15, 2018

      Identification

      DOI: https://doi.org/10.1016/j.ijcard.2018.02.072

      Copyright

      © 2018 Elsevier B.V. All rights reserved.

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