Department of Molecular Toxicology German Institute of Human Nutrition Potsdam-Rehbruecke Germany.
German Centre for Cardiovascular Research (partner site Berlin) Berlin Germany.
J Am Heart Assoc. 2021 Dec 7;10(23):e023131. doi: 10.1161/JAHA.121.023131. Epub 2021 Nov 15.
Background Degenerative aortic valve (AoV) disease and resulting aortic stenosis are major clinical health problems. Murine models of valve disease are rare, resulting in a translational knowledge gap on underlying mechanisms, functional consequences, and potential therapies. Naïve New Zealand obese (NZO) mice were recently found to have a dramatic decline of left ventricular (LV) function at early age. Therefore, we aimed to identify the underlying cause of reduced LV function in NZO mice. Methods and Results Cardiac function and pulmonary hemodynamics of NZO and age-matched C57BL/6J mice were monitored by serial echocardiographic examinations. AoVs in NZO mice demonstrated extensive thickening, asymmetric aortic leaflet formation, and cartilaginous transformation of the valvular stroma. Doppler echocardiography of the aorta revealed increased peak velocity profiles, holodiastolic flow reversal, and dilatation of the ascending aorta, consistent with aortic stenosis and regurgitation. Compensated LV hypertrophy deteriorated to decompensated LV failure and remodeling, as indicated by increased LV mass, interstitial fibrosis, and inflammatory cell infiltration. Elevated LV pressures in NZO mice were associated with lung congestion and , evident as right ventricular dilatation, decreased right ventricular function, and increased mean right ventricular systolic pressure, indicative for the development of pulmonary hypertension and ultimately right ventricular failure. Conclusions NZO mice demonstrate as a novel murine model to spontaneously develop degenerative AoV disease, aortic stenosis, and the associated end organ damages of both ventricles and the lung. Closely mimicking the clinical scenario of degenerative AoV disease, the model may facilitate a better mechanistic understanding and testing of novel treatment strategies in degenerative AoV disease.
退行性主动脉瓣(AoV)疾病和由此导致的主动脉瓣狭窄是主要的临床健康问题。用于瓣膜疾病的鼠模型较为少见,导致对潜在机制、功能后果和潜在治疗方法的转化知识存在差距。最近发现,新西兰肥胖(NZO)小鼠在早期左心室(LV)功能会明显下降。因此,我们旨在确定 NZO 小鼠 LV 功能下降的根本原因。
通过连续超声心动图检查监测 NZO 和年龄匹配的 C57BL/6J 小鼠的心脏功能和肺血液动力学。NZO 小鼠的 AoV 显示出广泛的增厚、不对称的主动脉瓣叶形成和瓣膜基质的软骨转化。主动脉多普勒超声心动图显示峰值速度谱升高、全舒张期血流反转和升主动脉扩张,与主动脉瓣狭窄和反流一致。代偿性 LV 肥厚恶化至失代偿性 LV 衰竭和重塑,表现为 LV 质量增加、间质纤维化和炎症细胞浸润。NZO 小鼠的 LV 压力升高与肺充血有关,表现为右心室扩张、右心室功能下降和平均右心室收缩压升高,提示肺动脉高压和最终右心室衰竭的发展。
NZO 小鼠自发形成退行性 AoV 疾病、主动脉瓣狭窄以及两个心室和肺部的相关终末器官损伤的新型鼠模型。该模型非常类似于退行性 AoV 疾病的临床情况,可能有助于更好地理解退行性 AoV 疾病的潜在机制,并对退行性 AoV 疾病的新治疗策略进行测试。