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Goodyke, A.

Publications and source records attributed to Goodyke, A..

4 recordsLinked to original sources

Incomplete Reverse Remodeling of the Tricuspid Valve Leaflets Following Relief of Pressure Overload

Objective(s)Tricuspid valve (TV) remodeling and functional tricuspid regurgitation (FTR) progression during right ventricular (RV) pressure overload and reverse remodeling after resolution of RV afterload is poorly understood. We set out to investigate tricuspid leaflet tissue response to induction and subsequent alleviation of pressure overload in a large animal model of RV failure with FTR. MethodsFifteen healthy adult male Dorset sheep (72{+/-}4 kg) underwent pulmonary artery banding (PAB) to induce RV failure and FTR. After 8 weeks, 7 sheep (PAB, n=7) were terminated, and remaining 8 had the PAB removed (rPAB, n=8) and were followed for another 8 weeks before termination. Both groups underwent epicardial echocardiography and hemodynamic assessment during banding surgery and at terminal operation. Ten healthy sheep served as a control group (CTL, n=10) and underwent terminal procedure only. In all animals, TV leaflets and right ventricular (RV) tissue were harvested at terminal procedure and analyzed histologically and transcriptionally. ResultsTV leaflets in PAB animals showed increased cross-sectional area and ECM alterations, some of which persisted after resolution of RV pressure overload. rPAB valves exhibited distinct ECM composition, with notably altered mucin and fibrin content, suggesting a shift toward matrix stabilization, dissimilar to control and PAB. RNA sequencing uncovered a unique molecular state in rPAB valves, with persistent changes in PRG4, PDE3A, CXCL8, and HLA transcripts. RV tissue also demonstrated a separate remodeling trajectory, with sustained expression of stress-related genes including PDE3A, NAV2, ANFB, and ACTS. These findings indicate that both valve and ventricular tissues retain a persistent remodeled phenotype post-unloading. ConclusionsTV leaflets actively remodel in response to hemodynamic stress and do not fully revert to a normal state after relief of pressure overload. This persistent altered phenotype may represent a biological contribution of the TV leaflets to recurrent TR with implications for long-term outcomes following treatment of FTR. Clinical Perspective What is new?O_LIRelief of right ventricular pressure overload, in a large animal model, resulted in substantial reverse remodeling of the right heart and reduction of tricuspid regurgitation severity, but tricuspid valve leaflets did not return to a normal state. C_LIO_LIReverse remodeled leaflets remained enlarged despite normalization of hemodynamics with an altered extracellular matrix. C_LIO_LICellular proliferation and immune cell infiltration observed during pressure overload resolved after unloading, yet transcriptomic analysis identified a distinct molecular phenotype that differed from both healthy and diseased valves. C_LIO_LITricuspid valve leaflets are active biological participants in the remodeling process and exhibit persistent adaptation or maladaptation after resolution of the initiating hemodynamic stress. C_LI What Are the Clinical Implications?O_LISecondary tricuspid regurgitation should be considered a disease involving both right heart geometry and leaflet biology. C_LIO_LIResolution of the underlying cause of tricuspid regurgitation may not restore leaflet structure and molecular homeostasis. C_LIO_LIPersistent leaflet remodeling may contribute to residual or recurrent tricuspid regurgitation despite successful treatment of pulmonary hypertension or other inciting conditions. C_LIO_LITherapies directed at leaflet remodeling may ultimately complement surgical and transcatheter strategies currently focused on annular and ventricular geometry. C_LI

physiology↗

The Tricuspid Valve Maladapts in a Pulmonary Hypertension Rat Model

Tricuspid valve regurgitation is a frequent valve lesion and, if severe, an independent predictor of mortality. In most patients, the valve itself has historically been considered intact. Yet, we have previously shown that the valve may not be an innocent bystander. In multiple sheep models, we have shown that the tricuspid valve thickens and stiffens. This remodeling may contribute to valve disease. Our goal is to extend our investigation of tricuspid valve remodeling to a rodent model, potentially opening scientific opportunity and enabling scaling our studies. To this end, we used pulmonary artery banding (PAB) in male rats to induce pressure overload and right ventricular remodeling. After excising the tricuspid valve, we quantified anterior leaflet morphology, mapped anterior leaflet thickness using optical coherence tomography, and evaluated anterior leaflet belly mechanics using a custom bulge testing system. Compared with SHAM controls, PAB increased anterior leaflet area. Moreover, anterior leaflets in PAB animals exhibited region-specific thickening, with the largest increases near the annulus. Finally, anterior leaflets in PAB animals were significantly less compliant. However, leaflet stiffening stemmed from aforementioned thickening, i.e., structural stiffening, not constitutive stiffening. Our findings demonstrate that we can reliably quantify leaflet area, thickness, and stiffness in the minuscule tricuspid valves of rats. We also show that tricuspid valve remodeling is not ovine-specific, but also affects the tricuspid valves of rats. Together, our findings support our hypothesis that tricuspid valves are not innocent bystanders in regurgitation, and that rats may serve as a scalable model system for future investigations. NEW & NOTEWORTHYUsing a rat pulmonary artery banding model of pulmonary hypertension, we show that chronic right ventricular pressure overload induces leaflet enlargement and region-specific thickness remodeling of the tricuspid valve. Although structural mechanical metrics change under pressure loading, normalization by thickness reveals that geometric remodeling rather than intrinsic material stiffening predominates. These findings highlight leaflet structural (mal)adaptation as a potential contributor to functional tricuspid regurgitation and underscore the importance of considering leaflet geometry in therapeutic strategies.

physiology↗

Isolation free Identification and Phenotyping of First Trimester Extravillous Trophoblasts Residing in Cervical Fluid

Preeclampsia (PE) remains difficult to predict, particularly when it manifests late in gestation. To capture early placental signals, we profiled trophoblast cells sampled from the cervix in the first trimester using mass cytometry (CyTOF). We established protocols for clinical sample storage and applied spike-in reference control cells to deliver reproducible, batch-corrected protein measurements, thereby advancing CyTOF from a discovery tool to a translational platform. Within HLA-GCD45- cells, we identified canonical CK7 extravillous trophoblasts, as well as a previously unrecognized CK7-subset, and both subsets expressed placental proteins. Expression of PAPP-A, GAL-13, and GAL-14 was significantly altered in a pilot cohort of pregnancies that subsequently developed late-onset PE, distinguishing cases from controls at both single-marker and multivariate levels. These findings reveal unexpected trophoblast heterogeneity, demonstrate that placental alterations are detectable before the development of late-onset PE, and establish cervical trophoblast profiling as a promising platform for scalable biomarker discovery and first-trimester risk assessment in placenta-mediated disorders. Impact StatementFirst-trimester trophoblasts sampled from the cervix reveal early molecular changes associated with late-onset preeclampsia, while an isolation-free, reference-normalized CyTOF workflow establishes a scalable, clinically compatible platform for biomarker discovery and multicenter-ready early risk assessment in pregnancy.

cell biology↗

The Tricuspid Valve is Transcriptionally Active During Prolonged Pressure Overload, Right-Sided Heart Failure, and Valve Regurgitation

BackgroundRight-sided heart failure (RHF), in the presence of tricuspid valve regurgitation (TR), can result from left-sided heart failure (LHF), pulmonary hypertension (PH), or heart malformations. The occurrence of RHF and TR represents a critical indicator of hospitalization rates and all-cause mortality. However, RHF has remained understudied, specifically with respect to the tricuspid valve, with few animal models to investigate the transformative processes and identify novel interventions. MethodsUsing the outbred sheep (Ovis aries) model of pulmonary artery banding (PAB) that induces RHF and TR, we generated three batches of ribosomal reduced RNA sequencing for 354 samples (NCBI SRA PRJNA1182691) containing right ventricle, left ventricle, each tricuspid valve leaflet, each mitral valve leaflet, and the pulmonary artery that represents both male and female sheep. The reads were assembled into a de novo sheep heart transcriptome for differential analysis. ResultsThe de novo sheep heart transcriptome enhanced transcript mapping of reads by 43-45% in the heart valves relative to the known sheep reference transcriptome. The identified transcripts produce validated tissue-specific pathways in ventricles (2,756 isoforms), pulmonary arteries (535 isoforms), and valves (1,215 isoforms), with transcript differences between the mitral and tricuspid valve involved in extracellular and endocrine signaling. The transcriptome also produced robust sex differences encoded by sex chromosomes and autosomes, highlighting epigenetic and sex hormone differences in the heart. Echocardiography and differential expression suggest that 8 weeks after PAB, the right ventricle has extensive morphological changes and known stress-induced lipid processing dysregulation. At 16-weeks post-PAB, tricuspid valve leaflets show the most significant transcriptional changes, with alterations in endocrine and immune pathway genes involved in cellular and extracellular remodeling. Genes within the tricuspid valve with differential expression and known human or mouse heart phenotypes include FLNA, LTBP4, VDR, CR2, PIGQ, CENPF, ACKR3, CR1, KLF2, and HIF3A. ConclusionsThis project highlights the complexity of heart valve tissues and their transcriptional activity in a sheep model of RHF. It suggests potential therapeutic interventions in heart valve remodeling in PAH, RHF, and TR. This work highlights the need for further human and model organism research into the dynamic valve cells and genes. Clinical PerspectiveO_ST_ABSWhat Is New?C_ST_ABS- Improved cardiac and valve specific transcriptome mapping through de novo transcriptome for clinically relevant ovine model. - Tricuspid valves show a sex dependent and active transcriptional response to pulmonary artery banding induced pulmonary hypertension and right sided heart failure. - Transcriptional phenotypes in ovine model mirror known human heart disease phenotypes. - Several transcripts identified with therapeutic potential for treating pressure overload conditions such as pulmonary hypertension. What Are the Clinical Implications?- Tricuspid valve remodeling due to pulmonary hypertension is accompanied by transcriptional alterations, and mechanical alterations alone may not be sufficient to address valve insufficiency. - Valve and ventricle sex specific gene expression changes following pulmonary hypertension indicate a potential role for hormonal influences and a need for personalized treatment strategies. - Improved patient outcomes for right heart failure, including diagnosis, early detection, and improved treatment strategies can be elucidated through the ovine model and supported through expanded interrogation of human tissues.

genomics↗