Chordal transection to induce severe mitral valve regurgitation significantly increased left ventricular end-diastolic volume by 34.5 ml compared to 8.4 ml in the sham group at four weeks.
Does a novel technique of chordal transection using a custom-made retractor induce severe mitral regurgitation and subsequent volume-overload heart failure in a porcine model?
This novel porcine model successfully and reproducibly induces primary mitral regurgitation and subsequent volume-overload heart failure, providing a valuable platform for translational cardiovascular research.
Absolute Event Rate: 34.5% vs 8.4%
p-value: p=0.023
Abstract Heart failure (HF) is a common disease resulting in high morbidity, mortality, and healthcare costs. An important cause of HF is mitral valve regurgitation (MR), which induces left ventricular remodeling and volume overload. For HF research, a reproducible and reliable large animal model is crucial. Several MR models have been developed, but they often show high variability in MR severity and MR jet characteristics, as well as an underlying ischemic cardiomyopathy, which may increase the risk of complications during follow-up. We present a straightforward and uniform porcine model of primary MR-induced HF. A custom-made retractor was used to induce severe and uniform MR by chordal rupture. After four weeks, severe MR led to significant left ventricular remodeling compared to the sham group, with a significant increase in left ventricular end-diastolic (+34.5 ± 6.8 ml vs. +8.4 ± 5.3 ml, p = 0.023) and end-systolic volume (+29.9 ± 4.0 ml vs. +4.2 ± 2.9 ml, p = 0.001), a decrease in left ventricular ejection fraction (-11.9 ± 1.9% vs. -0.7 ± 0.9%, p < 0.001) and fractional shortening (-12.2 ± 1.3% vs. -2.2 ± 0.8%, p < 0.001), and a higher amount of left ventricular fibrosis (12.6 ± 1.0% vs. 6.4 ± 0.9%, p = 0.001). This porcine model allows a straightforward and reproducible induction of primary MR-induced HF, with a high success rate. It could be valuable in basic research to study the underlying pathophysiology and in translational research to develop novel diagnostics and therapeutics targeting volume-overload induced HF and/or primary MR.
Laer et al. (2026) studied Heart failure (n=25). Chordal transection to induce severe mitral valve regurgitation vs. Sham procedure was evaluated on Change in left ventricular end-diastolic volume (LVEDV) (p=0.023). Chordal transection to induce severe mitral valve regurgitation significantly increased left ventricular end-diastolic volume by 34.5 ml compared to 8.4 ml in the sham group at four weeks.