Skip to main content
Top
Published in: Respiratory Research 1/2015

Open Access 01-12-2015 | Research

Alveolar macrophages support interferon gamma-mediated viral clearance in RSV-infected neonatal mice

Authors: Katherine M. Eichinger, Loreto Egaña, Jacob G. Orend, Erin Resetar, Kacey B. Anderson, Ravi Patel, Kerry M. Empey

Published in: Respiratory Research | Issue 1/2015

Login to get access

Abstract

Background

Poor interferon gamma (IFNγ) production during respiratory syncytial virus (RSV) is associated with prolonged viral clearance and increased disease severity in neonatal mice and humans. We previously showed that intra-nasal delivery of IFNγ significantly enhances RSV clearance from neonatal lungs prior to observed T-lymphocyte recruitment or activation, suggesting an innate immune mechanism of viral clearance. We further showed that alveolar macrophages dominate the RSV-infected neonatal airways relative to adults, consistent with human neonatal autopsy data. Therefore, the goal of this work was to determine the role of neonatal alveolar macrophages in IFNγ-mediated RSV clearance.

Methods

Clodronate liposomes, flow cytometry, viral plaque assays, and histology were used to examine the role of alveolar macrophages (AMs) and the effects of intra-nasal IFNγ in RSV infected neonatal Balb/c mice. The functional outcomes of AM depletion were determined quantitatively by viral titers using plaque assay. Illness was assessed by measuring reduced weight gain.

Results

AM activation during RSV infection was age-dependent and correlated tightly with IFNγ exposure. Higher doses of IFNγ more efficiently stimulated AM activation and expedited RSV clearance without significantly affecting weight gain. The presence of AMs were independently associated with improved RSV clearance, whereas AM depletion but not IFNγ exposure, significantly impaired weight gain in RSV-infected neonates.

Conclusion

We show here for the first time, that IFNγ is critical for neonatal RSV clearance and that it depends, in part, on alveolar macrophages (AMs) for efficient viral clearing effects. Early reductions in viral burden are likely to have profound short- and long-term immune effects in the vulnerable post-natally developing lung environment. Studies are ongoing to elucidate the pathologic effects associated with early versus delayed RSV clearance in developing neonatal airways.
Literature
1.
go back to reference Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545–55.CrossRefPubMedPubMedCentral Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545–55.CrossRefPubMedPubMedCentral
2.
go back to reference Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ. Bronchiolitis-associated hospitalizations among US children, 1980–1996. JAMA. 1999;282:1440–6.CrossRefPubMed Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ. Bronchiolitis-associated hospitalizations among US children, 1980–1996. JAMA. 1999;282:1440–6.CrossRefPubMed
3.
go back to reference Leader S, Kohlhase K. Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000. J Pediatr. 2003;143:S127–32.CrossRefPubMed Leader S, Kohlhase K. Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000. J Pediatr. 2003;143:S127–32.CrossRefPubMed
4.
go back to reference Meissner HC, Long SS. Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. Pediatrics. 2003;112:1447–52.CrossRefPubMed Meissner HC, Long SS. Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. Pediatrics. 2003;112:1447–52.CrossRefPubMed
5.
go back to reference El Saleeby CM, Bush AJ, Harrison LM, Aitken JA, Devincenzo JP. Respiratory syncytial virus load, viral dynamics, and disease severity in previously healthy naturally infected children. J Infect Dis. 2011;204:996–1002.CrossRefPubMedPubMedCentral El Saleeby CM, Bush AJ, Harrison LM, Aitken JA, Devincenzo JP. Respiratory syncytial virus load, viral dynamics, and disease severity in previously healthy naturally infected children. J Infect Dis. 2011;204:996–1002.CrossRefPubMedPubMedCentral
6.
go back to reference DeVincenzo JP, Wilkinson T, Vaishnaw A, Cehelsky J, Meyers R, Nochur S, et al. Viral load drives disease in humans experimentally infected with respiratory syncytial virus. Am J Respir Crit Care Med. 2010;182:1305–14.CrossRefPubMedPubMedCentral DeVincenzo JP, Wilkinson T, Vaishnaw A, Cehelsky J, Meyers R, Nochur S, et al. Viral load drives disease in humans experimentally infected with respiratory syncytial virus. Am J Respir Crit Care Med. 2010;182:1305–14.CrossRefPubMedPubMedCentral
7.
go back to reference Bagga B, Woods CW, Veldman TH, Gilbert A, Mann A, Balaratnam G, et al. Comparing influenza and RSV viral and disease dynamics in experimentally infected adults predicts clinical effectiveness of RSV antivirals. Antivir Ther. 2013;18:785–91.CrossRefPubMed Bagga B, Woods CW, Veldman TH, Gilbert A, Mann A, Balaratnam G, et al. Comparing influenza and RSV viral and disease dynamics in experimentally infected adults predicts clinical effectiveness of RSV antivirals. Antivir Ther. 2013;18:785–91.CrossRefPubMed
8.
go back to reference DeVincenzo JP, El Saleeby CM, Bush AJ. Respiratory syncytial virus load predicts disease severity in previously healthy infants. J Infect Dis. 2005;191:1861–8.CrossRefPubMed DeVincenzo JP, El Saleeby CM, Bush AJ. Respiratory syncytial virus load predicts disease severity in previously healthy infants. J Infect Dis. 2005;191:1861–8.CrossRefPubMed
9.
go back to reference Welliver TP, Reed JL, Welliver Sr RC. Respiratory syncytial virus and influenza virus infections: observations from tissues of fatal infant cases. Pediatr Infect Dis J. 2008;27:S92–6.CrossRefPubMed Welliver TP, Reed JL, Welliver Sr RC. Respiratory syncytial virus and influenza virus infections: observations from tissues of fatal infant cases. Pediatr Infect Dis J. 2008;27:S92–6.CrossRefPubMed
10.
go back to reference Sarzotti M, Gomes Mda P, Hoffman PM. IFN-gamma production in response to neuropathogenic Cas-Br-M murine leukemia virus infection. Viral Immunol. 1993;6:207–17.CrossRefPubMed Sarzotti M, Gomes Mda P, Hoffman PM. IFN-gamma production in response to neuropathogenic Cas-Br-M murine leukemia virus infection. Viral Immunol. 1993;6:207–17.CrossRefPubMed
11.
go back to reference Seder RA, Paul WE. Acquisition of lymphokine-producing phenotype by CD4+ T cells. Annu Rev Immunol. 1994;12:635–73.CrossRefPubMed Seder RA, Paul WE. Acquisition of lymphokine-producing phenotype by CD4+ T cells. Annu Rev Immunol. 1994;12:635–73.CrossRefPubMed
12.
go back to reference Butts C, Zubkoff I, Robbins DS, Cao S, Sarzotti M. DNA immunization of infants: potential and limitations. Vaccine. 1998;16:1444–9.CrossRefPubMed Butts C, Zubkoff I, Robbins DS, Cao S, Sarzotti M. DNA immunization of infants: potential and limitations. Vaccine. 1998;16:1444–9.CrossRefPubMed
13.
go back to reference Schroder K, Hertzog PJ, Ravasi T, Hume DA. Interferon-gamma: an overview of signals, mechanisms and functions. J Leukoc Biol. 2004;75:163–89.CrossRefPubMed Schroder K, Hertzog PJ, Ravasi T, Hume DA. Interferon-gamma: an overview of signals, mechanisms and functions. J Leukoc Biol. 2004;75:163–89.CrossRefPubMed
14.
go back to reference Futata EA, Fusaro AE, de Brito CA, Sato MN. The neonatal immune system: immunomodulation of infections in early life. Expert Rev Anti Infect Ther. 2012;10:289–98.CrossRefPubMed Futata EA, Fusaro AE, de Brito CA, Sato MN. The neonatal immune system: immunomodulation of infections in early life. Expert Rev Anti Infect Ther. 2012;10:289–98.CrossRefPubMed
15.
go back to reference Openshaw PJ. Antiviral immune responses and lung inflammation after respiratory syncytial virus infection. Proc Am Thorac Soc. 2005;2:121–5.CrossRefPubMed Openshaw PJ. Antiviral immune responses and lung inflammation after respiratory syncytial virus infection. Proc Am Thorac Soc. 2005;2:121–5.CrossRefPubMed
16.
go back to reference Hoebee B, Rietveld E, Bont L, Oosten M, Hodemaekers HM, Nagelkerke NJ, et al. Association of severe respiratory syncytial virus bronchiolitis with interleukin-4 and interleukin-4 receptor alpha polymorphisms. J Infect Dis. 2003;187:2–11.CrossRefPubMed Hoebee B, Rietveld E, Bont L, Oosten M, Hodemaekers HM, Nagelkerke NJ, et al. Association of severe respiratory syncytial virus bronchiolitis with interleukin-4 and interleukin-4 receptor alpha polymorphisms. J Infect Dis. 2003;187:2–11.CrossRefPubMed
17.
go back to reference Lee FE, Walsh EE, Falsey AR, Lumb ME, Okam NV, Liu N, et al. Human infant respiratory syncytial virus (RSV)-specific type 1 and 2 cytokine responses ex vivo during primary RSV infection. J Infect Dis. 2007;195:1779–88.CrossRefPubMed Lee FE, Walsh EE, Falsey AR, Lumb ME, Okam NV, Liu N, et al. Human infant respiratory syncytial virus (RSV)-specific type 1 and 2 cytokine responses ex vivo during primary RSV infection. J Infect Dis. 2007;195:1779–88.CrossRefPubMed
18.
go back to reference Gentile DA, Doyle WJ, Zeevi A, Howe-Adams J, Kapadia S, Trecki J, et al. Cytokine gene polymorphisms moderate illness severity in infants with respiratory syncytial virus infection. Hum Immunol. 2003;64:338–44.CrossRefPubMed Gentile DA, Doyle WJ, Zeevi A, Howe-Adams J, Kapadia S, Trecki J, et al. Cytokine gene polymorphisms moderate illness severity in infants with respiratory syncytial virus infection. Hum Immunol. 2003;64:338–44.CrossRefPubMed
19.
go back to reference Welliver TP, Garofalo RP, Hosakote Y, Hintz KH, Avendano L, Sanchez K, et al. Severe human lower respiratory tract illness caused by respiratory syncytial virus and influenza virus is characterized by the absence of pulmonary cytotoxic lymphocyte responses. J Infect Dis. 2007;195:1126–36.CrossRefPubMed Welliver TP, Garofalo RP, Hosakote Y, Hintz KH, Avendano L, Sanchez K, et al. Severe human lower respiratory tract illness caused by respiratory syncytial virus and influenza virus is characterized by the absence of pulmonary cytotoxic lymphocyte responses. J Infect Dis. 2007;195:1126–36.CrossRefPubMed
20.
go back to reference Johnson JE, Gonzales RA, Olson SJ, Wright PF, Graham BS. The histopathology of fatal untreated human respiratory syncytial virus infection. Mod Pathol. 2007;20:108–19.CrossRefPubMed Johnson JE, Gonzales RA, Olson SJ, Wright PF, Graham BS. The histopathology of fatal untreated human respiratory syncytial virus infection. Mod Pathol. 2007;20:108–19.CrossRefPubMed
21.
go back to reference Harker JA, Lee DC, Yamaguchi Y, Wang B, Bukreyev A, Collins PL, et al. Delivery of cytokines by recombinant virus in early life alters the immune response to adult lung infection. J Virol. 2010;84:5294–302.CrossRefPubMedPubMedCentral Harker JA, Lee DC, Yamaguchi Y, Wang B, Bukreyev A, Collins PL, et al. Delivery of cytokines by recombinant virus in early life alters the immune response to adult lung infection. J Virol. 2010;84:5294–302.CrossRefPubMedPubMedCentral
22.
go back to reference Lee YM, Miyahara N, Takeda K, Prpich J, Oh A, Balhorn A, et al. IFN-gamma production during initial infection determines the outcome of reinfection with respiratory syncytial virus. Am J Respir Crit Care Med. 2008;177:208–18.CrossRefPubMed Lee YM, Miyahara N, Takeda K, Prpich J, Oh A, Balhorn A, et al. IFN-gamma production during initial infection determines the outcome of reinfection with respiratory syncytial virus. Am J Respir Crit Care Med. 2008;177:208–18.CrossRefPubMed
23.
go back to reference Empey KM, Orend JG, Peebles Jr RS, Egana L, Norris KA, Oury TD, et al. Stimulation of immature lung macrophages with intranasal interferon gamma in a novel neonatal mouse model of respiratory syncytial virus infection. PLoS ONE. 2012;7:e40499.CrossRefPubMedPubMedCentral Empey KM, Orend JG, Peebles Jr RS, Egana L, Norris KA, Oury TD, et al. Stimulation of immature lung macrophages with intranasal interferon gamma in a novel neonatal mouse model of respiratory syncytial virus infection. PLoS ONE. 2012;7:e40499.CrossRefPubMedPubMedCentral
24.
go back to reference Kling HM, Nau GJ, Ross TM, Evans TG, Chakraborty K, Empey KM, et al. Challenges and future in vaccines, drug development, and immunomodulatory therapy. Ann Am Thorac Soc. 2014;11 Suppl 4:S201–10.CrossRefPubMedPubMedCentral Kling HM, Nau GJ, Ross TM, Evans TG, Chakraborty K, Empey KM, et al. Challenges and future in vaccines, drug development, and immunomodulatory therapy. Ann Am Thorac Soc. 2014;11 Suppl 4:S201–10.CrossRefPubMedPubMedCentral
25.
go back to reference Graham BSPM, Wright PF, Karzon DT. Primary respiratory syncytial virus infection in mice. J Med Virol. 1988;26:153–62.CrossRefPubMed Graham BSPM, Wright PF, Karzon DT. Primary respiratory syncytial virus infection in mice. J Med Virol. 1988;26:153–62.CrossRefPubMed
26.
go back to reference Empey KMOJ, Stokes Peebles R, Egana L, Norris KA, Oury TD, Kolls JK. Stimulation of immature lung macrophages with intranasal interferon gamma in a novel neonatal mouse model of respiratory syncytial virus infection. PLoS One. 2012;7. Empey KMOJ, Stokes Peebles R, Egana L, Norris KA, Oury TD, Kolls JK. Stimulation of immature lung macrophages with intranasal interferon gamma in a novel neonatal mouse model of respiratory syncytial virus infection. PLoS One. 2012;7.
27.
go back to reference Empey KM, Hollifield M, Garvy BA. Exogenous heat-killed Escherichia coli improves alveolar macrophage activity and reduces Pneumocystis carinii lung burden in infant mice. Infect Immun. 2007;75:3382–93.CrossRefPubMedPubMedCentral Empey KM, Hollifield M, Garvy BA. Exogenous heat-killed Escherichia coli improves alveolar macrophage activity and reduces Pneumocystis carinii lung burden in infant mice. Infect Immun. 2007;75:3382–93.CrossRefPubMedPubMedCentral
28.
go back to reference McDuffie E, Obert L, Chupka J, Sigler R. Detection of cytokine protein expression in mouse lung homogenates using suspension bead array. J Inflamm (Lond). 2006;3:15.CrossRef McDuffie E, Obert L, Chupka J, Sigler R. Detection of cytokine protein expression in mouse lung homogenates using suspension bead array. J Inflamm (Lond). 2006;3:15.CrossRef
29.
30.
go back to reference Kurkjian C, Hollifield M, Lines JL, Rogosky A, Empey KM, Qureshi M, et al. Alveolar macrophages in neonatal mice are inherently unresponsive to Pneumocystis murina infection. Infect Immun. 2012;80:2835–46.CrossRefPubMedPubMedCentral Kurkjian C, Hollifield M, Lines JL, Rogosky A, Empey KM, Qureshi M, et al. Alveolar macrophages in neonatal mice are inherently unresponsive to Pneumocystis murina infection. Infect Immun. 2012;80:2835–46.CrossRefPubMedPubMedCentral
31.
go back to reference Marodi L. Deficient interferon-gamma receptor-mediated signaling in neonatal macrophages. Acta Paediatr Suppl. 2002;91:117–9.CrossRefPubMed Marodi L. Deficient interferon-gamma receptor-mediated signaling in neonatal macrophages. Acta Paediatr Suppl. 2002;91:117–9.CrossRefPubMed
32.
go back to reference García C, Soriano-Fallas A, Lozano J, Leos N, Gomez AM, Ramilo O, et al. Decreased innate immune cytokine responses correlate with disease severity in children with respiratory syncytial virus and human rhinovirus bronchiolitis. Pediatr Infect Dis J. 2012;31:86–9.CrossRefPubMed García C, Soriano-Fallas A, Lozano J, Leos N, Gomez AM, Ramilo O, et al. Decreased innate immune cytokine responses correlate with disease severity in children with respiratory syncytial virus and human rhinovirus bronchiolitis. Pediatr Infect Dis J. 2012;31:86–9.CrossRefPubMed
33.
go back to reference Cohn L, Homer RJ, Niu N, Bottomly K. T helper 1 cells and interferon gamma regulate allergic airway inflammation and mucus production. J Exp Med. 1999;190:1309–18.CrossRefPubMedPubMedCentral Cohn L, Homer RJ, Niu N, Bottomly K. T helper 1 cells and interferon gamma regulate allergic airway inflammation and mucus production. J Exp Med. 1999;190:1309–18.CrossRefPubMedPubMedCentral
34.
go back to reference Cho SH, Oh SY, Lane AP, Lee J, Oh MH, Lee S, et al. Regulation of nasal airway homeostasis and inflammation in mice by SHP-1 and Th2/Th1 signaling pathways. PLoS One. 2014;9:e103685.CrossRefPubMedPubMedCentral Cho SH, Oh SY, Lane AP, Lee J, Oh MH, Lee S, et al. Regulation of nasal airway homeostasis and inflammation in mice by SHP-1 and Th2/Th1 signaling pathways. PLoS One. 2014;9:e103685.CrossRefPubMedPubMedCentral
35.
go back to reference Hong JY, Bentley JK, Chung Y, Lei J, Steenrod JM, Chen Q, et al. Neonatal rhinovirus induces mucous metaplasia and airways hyperresponsiveness through IL-25 and type 2 innate lymphoid cells. J Allergy Clin Immunol. 2014;134:429–39.CrossRefPubMedPubMedCentral Hong JY, Bentley JK, Chung Y, Lei J, Steenrod JM, Chen Q, et al. Neonatal rhinovirus induces mucous metaplasia and airways hyperresponsiveness through IL-25 and type 2 innate lymphoid cells. J Allergy Clin Immunol. 2014;134:429–39.CrossRefPubMedPubMedCentral
36.
go back to reference Shieh YH, Huang HM, Wang CC, Lee CC, Fan CK, Lee YL. Zerumbone enhances the Th1 response and ameliorates ovalbumin-induced Th2 responses and airway inflammation in mice. Int Immunopharmacol. 2015;24:383–91.CrossRefPubMed Shieh YH, Huang HM, Wang CC, Lee CC, Fan CK, Lee YL. Zerumbone enhances the Th1 response and ameliorates ovalbumin-induced Th2 responses and airway inflammation in mice. Int Immunopharmacol. 2015;24:383–91.CrossRefPubMed
37.
go back to reference Bitko V, Shulyayeva O, Mazumder B, Musiyenko A, Ramaswamy M, Look DC, et al. Nonstructural proteins of respiratory syncytial virus suppress premature apoptosis by an NF-kappaB-dependent, interferon-independent mechanism and facilitate virus growth. J Virol. 2007;81:1786–95.CrossRefPubMed Bitko V, Shulyayeva O, Mazumder B, Musiyenko A, Ramaswamy M, Look DC, et al. Nonstructural proteins of respiratory syncytial virus suppress premature apoptosis by an NF-kappaB-dependent, interferon-independent mechanism and facilitate virus growth. J Virol. 2007;81:1786–95.CrossRefPubMed
38.
go back to reference Kotelkin A, Prikhod’ko EA, Cohen JI, Collins PL, Bukreyev A. Respiratory syncytial virus infection sensitizes cells to apoptosis mediated by tumor necrosis factor-related apoptosis-inducing ligand. J Virol. 2003;77:9156–72.CrossRefPubMedPubMedCentral Kotelkin A, Prikhod’ko EA, Cohen JI, Collins PL, Bukreyev A. Respiratory syncytial virus infection sensitizes cells to apoptosis mediated by tumor necrosis factor-related apoptosis-inducing ligand. J Virol. 2003;77:9156–72.CrossRefPubMedPubMedCentral
39.
go back to reference Wang S, Smith PK, Lovejoy M, Bowden JJ, Alpers JH, Forsyth KD. The apoptosis of neutrophils is accelerated in respiratory syncytial virus (RSV)-induced bronchiolitis. Clin Exp Immunol. 1998;114:49–54.CrossRefPubMedPubMedCentral Wang S, Smith PK, Lovejoy M, Bowden JJ, Alpers JH, Forsyth KD. The apoptosis of neutrophils is accelerated in respiratory syncytial virus (RSV)-induced bronchiolitis. Clin Exp Immunol. 1998;114:49–54.CrossRefPubMedPubMedCentral
40.
go back to reference Kumar M, Behera AK, Matsuse H, Lockey RF, Mohapatra SS. Intranasal IFN-γ gene transfer protects BALB/c mice against respiratory syncytial virus infection. Vaccine. 1999;18:558–67.CrossRefPubMed Kumar M, Behera AK, Matsuse H, Lockey RF, Mohapatra SS. Intranasal IFN-γ gene transfer protects BALB/c mice against respiratory syncytial virus infection. Vaccine. 1999;18:558–67.CrossRefPubMed
41.
go back to reference Yamada Y, Matsumoto K, Hashimoto N, Saikusa M, Homma T, Yoshihara S, et al. Effect of Th1/Th2 cytokine pretreatment on RSV-induced gene expression in airway epithelial cells. Int Arch Allergy Immunol. 2011;154:185–94.CrossRefPubMed Yamada Y, Matsumoto K, Hashimoto N, Saikusa M, Homma T, Yoshihara S, et al. Effect of Th1/Th2 cytokine pretreatment on RSV-induced gene expression in airway epithelial cells. Int Arch Allergy Immunol. 2011;154:185–94.CrossRefPubMed
Metadata
Title
Alveolar macrophages support interferon gamma-mediated viral clearance in RSV-infected neonatal mice
Authors
Katherine M. Eichinger
Loreto Egaña
Jacob G. Orend
Erin Resetar
Kacey B. Anderson
Ravi Patel
Kerry M. Empey
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2015
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-015-0282-7

Other articles of this Issue 1/2015

Respiratory Research 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.