Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, United States; Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
Tomasz Jazwiec
Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, United States; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
Xinmei Wang
Department of Chemical Engineering, Texas Tech University, Lubbock, United States
Carla MR Lacerda
Department of Chemical Engineering, Texas Tech University, Lubbock, United States
Tomasz A Timek
Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, United States
Department of Biomedical Engineering, The University of Texas at Austin, Austin, United States; Department of Mechanical Engineering, The University of Texas at Austin, Austin, United States; Department of Aerospace Engineering and Engineering Mechanics, The University of Texas at Austin, Austin, United States
Over 1.6 million Americans suffer from significant tricuspid valve leakage. In most cases this leakage is designated as secondary. Thus, valve dysfunction is assumed to be due to valve-extrinsic factors. We challenge this paradigm and hypothesize that the tricuspid valve maladapts in those patients rendering the valve at least partially culpable for its dysfunction. As a first step in testing this hypothesis, we set out to demonstrate that the tricuspid valve maladapts in disease. To this end, we induced biventricular heart failure in sheep that developed tricuspid valve leakage. In the anterior leaflets of those animals, we investigated maladaptation on multiple scales. We demonstrated alterations on the protein and cell-level, leading to tissue growth, thickening, and stiffening. These data provide a new perspective on a poorly understood, yet highly prevalent disease. Our findings may motivate novel therapy options for many currently untreated patients with leaky tricuspid valves.
