Development of transcatheter mitral valve interventions has ushered a significant need for large animal models of secondary mitral regurgitation. Though currently used heart failure models that chronically develop secondary mitral regurgitation are viable, the severity is lower than patients, the incubation time is long, and mortality is high. We sought to develop a swine model of acute secondary mitral regurgitation that uses image-guided placement of snares around the mitral chordae. Twenty-seven adult swine (n = 27) were assigned to secondary mitral regurgitation induced by valve tethering with image-guided chordal encircling snares (group 1, n = 7, tether MR (tMR)); secondary mitral regurgitation by percutaneous posterolateral myocardial infarction causing ventricular dysfunction and regurgitation (group 2, n = 6, functional MR (fMR)); and control animals (group 3, n = 14). Regurgitant fraction in tMR was 42.1 ± 14.2%, in fMR was 22 ± 9.6%, and in controls was 5.3 ± 3.8%. Mitral tenting height was 9.6 ± 1.3 mm in tMR, 10.1 ± 1.5 mm in fMR, and 5.8 ± 1.2 mm in controls. Chordal encircling tethers reproducibly induce clinically relevant levels of secondary mitral regurgitation, providing a new animal model for use in translational research.

Graphical abstract

中文翻译：

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图像引导靶向二尖瓣栓系与弦环圈套器作为继发性二尖瓣关闭不全的临床前模型

经导管二尖瓣介入治疗的发展引发了对继发性二尖瓣关闭不全的大型动物模型的巨大需求。虽然目前使用的慢性二尖瓣关闭不全的心力衰竭模型是可行的，但严重程度低于患者，潜伏期长，死亡率高。我们试图开发一种猪急性继发性二尖瓣反流模型，该模型使用图像引导的圈套器在二尖瓣腱索周围放置。27 头成年猪 ( n  = 27) 被分配到由使用图像引导的腱索环绕圈套器的瓣膜束缚引起的继发性二尖瓣关闭不全（第 1 组，n = 7，系绳 MR (tMR))；继发性二尖瓣反流由经皮后外侧心肌梗死引起心室功能障碍和反流（第 2 组，n  = 6，功能性 MR (fMR)）；和对照动物（第 3 组，n  = 14）。tMR 中的反流分数为 42.1 ± 14.2%，fMR 中为 22 ± 9.6%，对照组为 5.3 ± 3.8%。tMR 中的二尖瓣隆起高度为 9.6 ± 1.3 mm，fMR 中为 10.1 ± 1.5 mm，对照组为 5.8 ± 1.2 mm。环绕弦的系绳可重复地诱导临床相关水平的继发性二尖瓣反流，为转化研究提供了一种新的动物模型。

图形概要