Tricuspid Valve Anterior Leaflet Strains in Ovine Functional Tricuspid Regurgitation
| Autor: | Haley Ferguson, Marcin Malinowski, Mrudang Mathur, Tomasz Jazwiec, Manuel K. Rausch, Tomasz A. Timek, Jessica Parker |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty 030204 cardiovascular system & hematology Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Functional tricuspid regurgitation Internal medicine Medicine Animals cardiovascular diseases Functional mitral regurgitation Anterior leaflet Tricuspid valve Ejection fraction Sheep business.industry Central venous pressure Mitral Valve Insufficiency Stroke Volume General Medicine Tricuspid Valve Insufficiency Sonomicrometry medicine.anatomical_structure 030228 respiratory system Fractional area change cardiovascular system Cardiology Surgery Tricuspid Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | Seminars in thoracic and cardiovascular surgery. 33(2) |
| ISSN: | 1532-9488 |
| Popis: | Functional tricuspid regurgitation (FTR) is thought to arise due to annular dilation and alteration of right ventricular (RV) geometry in the presence of normal leaflets, yet mitral leaflets have been shown to remodel significantly in functional mitral regurgitation. We set out to evaluate tricuspid valve anterior leaflet deformations in ovine FTR. Eleven animals (FTR group) underwent implantation of a pacemaker with high rate pacing to induce biventricular dysfunction and at least moderate TR. Subsequently, both FTR (n = 11) and Control (n = 12) animals underwent implantation of 6 sonomicrometry crystals around the tricuspid annulus, 4 on the anterior leaflet, and 14 on RV epicardium. Tricuspid valve geometry and anterior leaflet strains were calculated from crystal coordinates. Left ventricular ejection fraction and RV fractional area change were significantly lower in FTR animals versus Control. Tricuspid annular area, septo-lateral diameter, RV pressures were all significantly greater in the FTR group. Mean TR grade (+0-3) was 0.7 ± 0.5 in Control and 2.4 ± 0.5 in FTR (P = 0.001). The anterior leaflet area and length increased significantly. Global radial leaflet strain was significantly lower in FTR mostly driven by decreased free edge leaflet strain. Global circumferential anterior leaflet strain was also significantly lower in FTR with more remarkable reduction in the belly region. Rapid ventricular pacing in sheep resulted in a clinically pertinent model of RV and annular dilation with FTR and leaflet enlargement. Both circumferential and radial anterior leaflet strains were significantly reduced with FTR. Functional TR may be associated with alteration of leaflet mechanical properties. |
| Databáze: | OpenAIRE |
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