Skip to main content
Top
Published in: Virology Journal 1/2021

01-12-2021 | Human Immunodeficiency Virus | Research

STING and cGAS gene expressions were downregulated among HIV-1-infected persons after antiretroviral therapy

Authors: Lorena Leticia Peixoto de Lima, Allysson Quintino Tenório de Oliveira, Tuane Carolina Ferreira Moura, Ednelza da Silva Graça Amoras, Sandra Souza Lima, Andrea Nazaré Monteiro Rangel da Silva, Maria Alice Freitas Queiroz, Izaura Maria Vieira Cayres-Vallinoto, Ricardo Ishak, Antonio Carlos Rosário Vallinoto

Published in: Virology Journal | Issue 1/2021

Login to get access

Abstract

Background

The HIV-1 epidemic is still considered a global public health problem, but great advances have been made in fighting it by antiretroviral therapy (ART). ART has a considerable impact on viral replication and host immunity. The production of type I interferon (IFN) is key to the innate immune response to viral infections. The STING and cGAS proteins have proven roles in the antiviral cascade. The present study aimed to evaluate the impact of ART on innate immunity, which was represented by STING and cGAS gene expression and plasma IFN-α level.

Methods

This cohort study evaluated a group of 33 individuals who were initially naïve to therapy and who were treated at a reference center and reassessed 12 months after starting ART. Gene expression levels and viral load were evaluated by real-time PCR, CD4+ and CD8+ T lymphocyte counts by flow cytometry, and IFN-α level by enzyme-linked immunosorbent assay.

Results

From before to after ART, the CD4+ T cell count and the CD4+/CD8+ ratio significantly increased (p < 0.0001), the CD8+ T cell count slightly decreased, and viral load decreased to undetectable levels in most of the group (84.85%). The expression of STING and cGAS significantly decreased (p = 0.0034 and p = 0.0001, respectively) after the use of ART, but IFN-α did not (p = 0.1558). Among the markers evaluated, the only markers that showed a correlation with each other were STING and CD4+ T at the time of the first collection.

Conclusions

ART provided immune recovery and viral suppression to the studied group and indirectly downregulated the STING and cGAS genes. In contrast, ART did not influence IFN-α. The expression of STING and cGAS was not correlated with the plasma level of IFN-α, which suggests that there is another pathway regulating this cytokine in addition to the STING–cGAS pathway.
Appendix
Available only for authorised users
Literature
2.
3.
go back to reference Dourado I, Veras MASM, Barreira D, Brito AM. Tendências da epidemia da Aids no Brasil após a terapia anti-retroviral. Rev Saúd Púb. 2006;40(6):9–17.CrossRef Dourado I, Veras MASM, Barreira D, Brito AM. Tendências da epidemia da Aids no Brasil após a terapia anti-retroviral. Rev Saúd Púb. 2006;40(6):9–17.CrossRef
4.
go back to reference Pádua E, Almeida C, Nunes B, Cortes Martins H, Castela J, et al. Assessment of mother-to-child HIV-1 and HIV-2 transmission: an AIDS reference laboratory collaborative study. HIV Med. 2009;10(3):182–90.PubMedCrossRef Pádua E, Almeida C, Nunes B, Cortes Martins H, Castela J, et al. Assessment of mother-to-child HIV-1 and HIV-2 transmission: an AIDS reference laboratory collaborative study. HIV Med. 2009;10(3):182–90.PubMedCrossRef
5.
go back to reference Günthard HF, Aberg JA, Eron JJ, Hoy JF, Telenti A, Benson CA, et al. Antiretroviral treatment of adult HIV infection: 2014 recommendations of the International Antiviral Society-USA Panel. JAMA. 2014;312(4):410–25.PubMedCrossRef Günthard HF, Aberg JA, Eron JJ, Hoy JF, Telenti A, Benson CA, et al. Antiretroviral treatment of adult HIV infection: 2014 recommendations of the International Antiviral Society-USA Panel. JAMA. 2014;312(4):410–25.PubMedCrossRef
6.
7.
go back to reference Berg RK, Melchjorsen J, Rintahaka J, Diget E, Søby S, Horan KA, et al. Genomic HIV RNA induces innate immune responses through RIG-I-dependent sensing of secondary-strutured RNA. PLoS ONE. 2012;7(1):e29291.PubMedPubMedCentralCrossRef Berg RK, Melchjorsen J, Rintahaka J, Diget E, Søby S, Horan KA, et al. Genomic HIV RNA induces innate immune responses through RIG-I-dependent sensing of secondary-strutured RNA. PLoS ONE. 2012;7(1):e29291.PubMedPubMedCentralCrossRef
9.
10.
go back to reference Cai X, Chiu YH, Chen ZJ. The cGAS-cGAMP-STING pathway of cytosolic DNA sensing and signaling. Mol Cell. 2014;54(2):289–96.PubMedCrossRef Cai X, Chiu YH, Chen ZJ. The cGAS-cGAMP-STING pathway of cytosolic DNA sensing and signaling. Mol Cell. 2014;54(2):289–96.PubMedCrossRef
12.
go back to reference Barber GN. STING-dependent cytosolic DNA sensing pathways. Trend Immunol. 2012;35(2):88–93.CrossRef Barber GN. STING-dependent cytosolic DNA sensing pathways. Trend Immunol. 2012;35(2):88–93.CrossRef
13.
14.
go back to reference Abe T, Barber GN. Cytosolic-DNA-mediated, STING-dependent proinflammatory gene induction necessitates canonical NF-κB activation through TBK1. J Virol. 2014;88(10):5328–41.PubMedPubMedCentralCrossRef Abe T, Barber GN. Cytosolic-DNA-mediated, STING-dependent proinflammatory gene induction necessitates canonical NF-κB activation through TBK1. J Virol. 2014;88(10):5328–41.PubMedPubMedCentralCrossRef
16.
go back to reference Konno H, Barber GN. The STING controlled cytosolic-DNA activated innate immune pathway and microbial disease. Microb Infect. 2014;16(12):998–1001.CrossRef Konno H, Barber GN. The STING controlled cytosolic-DNA activated innate immune pathway and microbial disease. Microb Infect. 2014;16(12):998–1001.CrossRef
18.
go back to reference Sunthamala N, Thierry F, Teissier S, Pientong C, Kongyingyoes B, Tangsiriwatthana T, et al. E2 proteins of high-risk human papillomaviruses downmodulate STING and IFN-κ transcription in keratinocytes. PLoS ONE. 2014;9(3):e91473.PubMedPubMedCentralCrossRef Sunthamala N, Thierry F, Teissier S, Pientong C, Kongyingyoes B, Tangsiriwatthana T, et al. E2 proteins of high-risk human papillomaviruses downmodulate STING and IFN-κ transcription in keratinocytes. PLoS ONE. 2014;9(3):e91473.PubMedPubMedCentralCrossRef
20.
go back to reference Rasaiyaah J, Tan CP, Fletcher AJ, Price AJ, Blondeau C, Hilditch L, et al. HIV-1 evades innate immune recognition through specific cofactor recruitment. Nature. 2013;503(7476):402–5.PubMedPubMedCentralCrossRef Rasaiyaah J, Tan CP, Fletcher AJ, Price AJ, Blondeau C, Hilditch L, et al. HIV-1 evades innate immune recognition through specific cofactor recruitment. Nature. 2013;503(7476):402–5.PubMedPubMedCentralCrossRef
21.
go back to reference Gao D, Wu J, Wu YT, Du F, Aroh C, Yan N, et al. Cyclic GMP-AMP synthase is an innate immune sensor of HIV and other retroviruses. Science. 2013;341(6148):903–6.PubMedCrossRef Gao D, Wu J, Wu YT, Du F, Aroh C, Yan N, et al. Cyclic GMP-AMP synthase is an innate immune sensor of HIV and other retroviruses. Science. 2013;341(6148):903–6.PubMedCrossRef
22.
go back to reference Vermeire J, Roesch F, Sauter D, Rua R, Hotter D, Van Nuffel A, et al. HIV triggers a cGAS-dependent, Vpu- and Vpr-regulated type i interferon response in CD4+ T CELLS. Cell Rep. 2016;17(2):413–24.PubMedCrossRef Vermeire J, Roesch F, Sauter D, Rua R, Hotter D, Van Nuffel A, et al. HIV triggers a cGAS-dependent, Vpu- and Vpr-regulated type i interferon response in CD4+ T CELLS. Cell Rep. 2016;17(2):413–24.PubMedCrossRef
23.
go back to reference Autran B, Carcelain G, Li TS, Blanc C, Mathez D, Tubiana R, et al. Positive Effects of Combined Antiretroviral Therapy on CD4+ T Cell Homeostasis and Function in Advanced HIV Disease. Science. 1997;277(5322):112–6.PubMedCrossRef Autran B, Carcelain G, Li TS, Blanc C, Mathez D, Tubiana R, et al. Positive Effects of Combined Antiretroviral Therapy on CD4+ T Cell Homeostasis and Function in Advanced HIV Disease. Science. 1997;277(5322):112–6.PubMedCrossRef
24.
go back to reference Gunda DW, Kilonzo SB, Kamugisha E, Rauya EZ, Mpondo BC. Prevalence and risk factors of poor immune recovery among adult HIV patients attending care and treatment centre in northwestern Tanzania following the use of highly active antiretroviral therapy: a retrospective study. BMC Res Not. 2017;10(1):197.PubMedPubMedCentralCrossRef Gunda DW, Kilonzo SB, Kamugisha E, Rauya EZ, Mpondo BC. Prevalence and risk factors of poor immune recovery among adult HIV patients attending care and treatment centre in northwestern Tanzania following the use of highly active antiretroviral therapy: a retrospective study. BMC Res Not. 2017;10(1):197.PubMedPubMedCentralCrossRef
25.
go back to reference Gulick RM, Mellors JW, Havlir D, Eron JJ, Gonzalez C, Mcmahon D, et al. Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. N Engl J Med. 1997;337(11):734–9.PubMedCrossRef Gulick RM, Mellors JW, Havlir D, Eron JJ, Gonzalez C, Mcmahon D, et al. Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. N Engl J Med. 1997;337(11):734–9.PubMedCrossRef
26.
go back to reference Erb P, Battegay M, Zimmerli W, Rickenbach M, Egger M. Effect of antiretroviral therapy on viral load, CD4 cell count, and progression to acquired immunodeficiency syndrome in a community human immunodeficiency virus-infected cohort. Arch Intern Med. 2000;160(11):1134–40.PubMedCrossRef Erb P, Battegay M, Zimmerli W, Rickenbach M, Egger M. Effect of antiretroviral therapy on viral load, CD4 cell count, and progression to acquired immunodeficiency syndrome in a community human immunodeficiency virus-infected cohort. Arch Intern Med. 2000;160(11):1134–40.PubMedCrossRef
27.
go back to reference May MT, Sterne JA, Costagliola D, Sabin CA, Philips AN, Justice AC, et al. Antiretroviral Therapy (ART) Cohort Collaboration. HIV treatment response and prognosis in Europe and North America in the first decade of highly active antiretroviral therapy: a collaborative analysis. Lancet. 2006;368(9534):451–8. May MT, Sterne JA, Costagliola D, Sabin CA, Philips AN, Justice AC, et al. Antiretroviral Therapy (ART) Cohort Collaboration. HIV treatment response and prognosis in Europe and North America in the first decade of highly active antiretroviral therapy: a collaborative analysis. Lancet. 2006;368(9534):451–8.
28.
go back to reference Pai NP, Estes M, Moodie EE, Reingold AL, Tulsky JP. The impact of antiretroviral therapy in a cohort of HIV infected patients going in and out of the San Francisco county jail. PLoS ONE. 2009;4(9):e7115.PubMedCrossRef Pai NP, Estes M, Moodie EE, Reingold AL, Tulsky JP. The impact of antiretroviral therapy in a cohort of HIV infected patients going in and out of the San Francisco county jail. PLoS ONE. 2009;4(9):e7115.PubMedCrossRef
29.
go back to reference Luecke S, Holleufer A, Christensen MH, Jønsson KL, Boni GA, Sørensen LK, et al. cGAS is activated by DNA in a length-dependent manner. EMBO Rep. 2017;18(10):1707–15.PubMedPubMedCentralCrossRef Luecke S, Holleufer A, Christensen MH, Jønsson KL, Boni GA, Sørensen LK, et al. cGAS is activated by DNA in a length-dependent manner. EMBO Rep. 2017;18(10):1707–15.PubMedPubMedCentralCrossRef
30.
go back to reference Nissen SK, Højen JF, Andersen KL, Kofod-Olsen E, Berg RK, Paludan SR, et al. Innate DNA sensing is impaired in HIV patients and IFI16 expression correlates with chronic immune activation. Clin Exp Immunol. 2014;177(1):295–309.PubMedPubMedCentralCrossRef Nissen SK, Højen JF, Andersen KL, Kofod-Olsen E, Berg RK, Paludan SR, et al. Innate DNA sensing is impaired in HIV patients and IFI16 expression correlates with chronic immune activation. Clin Exp Immunol. 2014;177(1):295–309.PubMedPubMedCentralCrossRef
31.
go back to reference Boulware DR, Meya DB, Bergemann TL, Williams D, Vlasova-St Louis IA, Rhein J, et al. Antiretroviral therapy down-regulates innate antiviral response genes in patients with AIDS in sub-saharan Africa. J Acquir Immun Defic Syndr. 2010;55(4):428–38.CrossRef Boulware DR, Meya DB, Bergemann TL, Williams D, Vlasova-St Louis IA, Rhein J, et al. Antiretroviral therapy down-regulates innate antiviral response genes in patients with AIDS in sub-saharan Africa. J Acquir Immun Defic Syndr. 2010;55(4):428–38.CrossRef
32.
go back to reference Li Q, Schacker T, Carlis J, Beilman G, Nguyen P, Haase AT. Functional genomic analysis of the response of HIV-1-infected lymphatic tissue to antiretroviral therapy. J Infect Dis. 2004;189(4):572–82.PubMedCrossRef Li Q, Schacker T, Carlis J, Beilman G, Nguyen P, Haase AT. Functional genomic analysis of the response of HIV-1-infected lymphatic tissue to antiretroviral therapy. J Infect Dis. 2004;189(4):572–82.PubMedCrossRef
33.
go back to reference Wang B, Kang W, Zuo J, Kang W, Sun Y. The Significance of Type-I Interferons in the Pathogenesis and Therapy of Human Immunodeficiency Virus 1 Infection. Front Immunol. 2017;8:1431.PubMedPubMedCentralCrossRef Wang B, Kang W, Zuo J, Kang W, Sun Y. The Significance of Type-I Interferons in the Pathogenesis and Therapy of Human Immunodeficiency Virus 1 Infection. Front Immunol. 2017;8:1431.PubMedPubMedCentralCrossRef
34.
go back to reference Soper A, Kimura I, Nagaoka S, Konno Y, Yamamoto K, Koyanagi Y, et al. Type I Interferon Responses by HIV-1 Infection: Association with Disease Progression and Control. Front Immunol. 2018;8:1823.PubMedPubMedCentralCrossRef Soper A, Kimura I, Nagaoka S, Konno Y, Yamamoto K, Koyanagi Y, et al. Type I Interferon Responses by HIV-1 Infection: Association with Disease Progression and Control. Front Immunol. 2018;8:1823.PubMedPubMedCentralCrossRef
35.
go back to reference Utay NS, Douek DC. Interferons and HIV infection: the good, the bad, and the ugly. Path Immun. 2016;1(1):107–16.CrossRef Utay NS, Douek DC. Interferons and HIV infection: the good, the bad, and the ugly. Path Immun. 2016;1(1):107–16.CrossRef
36.
go back to reference Solis M, Nakhaei P, Jalalirad M, Lacoste J, Douville R, Arguello M, et al. RIG-I-mediated antiviral signaling is inhibited in HIV-1 infection by a protease-mediated sequestration of RIG-I. J Virol. 2010;85(3):1224–36.PubMedPubMedCentralCrossRef Solis M, Nakhaei P, Jalalirad M, Lacoste J, Douville R, Arguello M, et al. RIG-I-mediated antiviral signaling is inhibited in HIV-1 infection by a protease-mediated sequestration of RIG-I. J Virol. 2010;85(3):1224–36.PubMedPubMedCentralCrossRef
37.
go back to reference Rigby RE, Webb LM, Mackenzie KJ, Li Y, Leitch A, Reijns MA, et al. RNA:DNA hybrids are a novel molecular pattern sensed by TLR9. EMBO J. 2014;33(6):542–58.PubMedPubMedCentralCrossRef Rigby RE, Webb LM, Mackenzie KJ, Li Y, Leitch A, Reijns MA, et al. RNA:DNA hybrids are a novel molecular pattern sensed by TLR9. EMBO J. 2014;33(6):542–58.PubMedPubMedCentralCrossRef
38.
go back to reference Zhao B, Shu C, Gao X, Sankaran B, Du F, Shelton CL, et al. Structural basis for concerted recruitment and activation of IRF-3 by innate immune adaptor proteins. Proc Natl Acad Sci USA. 2016;113(24):E3403-3412.PubMedCrossRefPubMedCentral Zhao B, Shu C, Gao X, Sankaran B, Du F, Shelton CL, et al. Structural basis for concerted recruitment and activation of IRF-3 by innate immune adaptor proteins. Proc Natl Acad Sci USA. 2016;113(24):E3403-3412.PubMedCrossRefPubMedCentral
39.
go back to reference French MA, King MS, Tschampa JM, Da Silva BA, Landay AL. Serum immune activation markers are persistently increased in patients with HIV infection after 6 years of antiretroviral therapy despite suppression of viral replication and reconstitution of CD4+ T cells. J Infect Dis. 2009;200(8):1212–5.PubMedCrossRef French MA, King MS, Tschampa JM, Da Silva BA, Landay AL. Serum immune activation markers are persistently increased in patients with HIV infection after 6 years of antiretroviral therapy despite suppression of viral replication and reconstitution of CD4+ T cells. J Infect Dis. 2009;200(8):1212–5.PubMedCrossRef
40.
go back to reference Malherbe G, Steel HC, Cassol S, De Oliveira T, Seebregts CJ, Anderson R, et al. Circulating biomarkers of immune activation distinguish viral suppression from nonsuppression in HAART-treated patients with advanced HIV-1 subtype C infection. Mediat Inflamm. 2014;2014:198413.CrossRef Malherbe G, Steel HC, Cassol S, De Oliveira T, Seebregts CJ, Anderson R, et al. Circulating biomarkers of immune activation distinguish viral suppression from nonsuppression in HAART-treated patients with advanced HIV-1 subtype C infection. Mediat Inflamm. 2014;2014:198413.CrossRef
42.
go back to reference Stavrou S, Blouch K, Kotla S, Bass A, Ross SR. Nucleic acid recognition orchestrates the anti-viral response to retroviruses. Cell Host Microb. 2015;17(4):478–88.CrossRef Stavrou S, Blouch K, Kotla S, Bass A, Ross SR. Nucleic acid recognition orchestrates the anti-viral response to retroviruses. Cell Host Microb. 2015;17(4):478–88.CrossRef
43.
go back to reference Kane M, Yadav SS, Bitzegeio J, Kutluay SB, Zang T, Wilson SJ, et al. MX2 is an interferon-induced inhibitor of HIV-1 infection. Nature. 2013;502(7472):563–6.PubMedPubMedCentralCrossRef Kane M, Yadav SS, Bitzegeio J, Kutluay SB, Zang T, Wilson SJ, et al. MX2 is an interferon-induced inhibitor of HIV-1 infection. Nature. 2013;502(7472):563–6.PubMedPubMedCentralCrossRef
44.
go back to reference Sivro A, Su RC, Plummer FA, Ball TB. HIV and interferon regulatory factor 1: a story of manipulation and control. AIDS Res Hum Retrov. 2013;29(11):1428–33.CrossRef Sivro A, Su RC, Plummer FA, Ball TB. HIV and interferon regulatory factor 1: a story of manipulation and control. AIDS Res Hum Retrov. 2013;29(11):1428–33.CrossRef
45.
go back to reference Nasr N, Alshehri AA, Wright TK, Shahid M, Heiner BM, Harman AN, et al. Mechanism of Interferon-Stimulated Gene Induction in HIV-1-Infected Macrophages. J Virol. 2017;91(20):e00744-e817.PubMedPubMedCentralCrossRef Nasr N, Alshehri AA, Wright TK, Shahid M, Heiner BM, Harman AN, et al. Mechanism of Interferon-Stimulated Gene Induction in HIV-1-Infected Macrophages. J Virol. 2017;91(20):e00744-e817.PubMedPubMedCentralCrossRef
46.
go back to reference Cerboni S, Jeremiah N, Gentili M, Gehrmann U, Conrad C, Stolzenberg MC, et al. Intrinsic antiproliferative activity of the innate sensor STING in T lymphocytes. J Exp Med. 2017;214(6):1769–85.PubMedPubMedCentralCrossRef Cerboni S, Jeremiah N, Gentili M, Gehrmann U, Conrad C, Stolzenberg MC, et al. Intrinsic antiproliferative activity of the innate sensor STING in T lymphocytes. J Exp Med. 2017;214(6):1769–85.PubMedPubMedCentralCrossRef
47.
go back to reference Martin-Gayo E, Buzon MJ, Ouyang Z, Hickman T, Cronin J, Pimenova D, et al. Potent cell-intrinsic immune responses in dendritic cells facilitate HIV-1-specific T cell immunity in HIV-1 elite controllers. PLoS Pathog. 2015;11(6):e1004930.PubMedPubMedCentralCrossRef Martin-Gayo E, Buzon MJ, Ouyang Z, Hickman T, Cronin J, Pimenova D, et al. Potent cell-intrinsic immune responses in dendritic cells facilitate HIV-1-specific T cell immunity in HIV-1 elite controllers. PLoS Pathog. 2015;11(6):e1004930.PubMedPubMedCentralCrossRef
48.
go back to reference Maelfait J, Bridgeman A, Benlahrech A, Cursi C, Rehwinkel J. Restriction by SAMHD1 limits cGAS/STING-dependent innate and adaptive immune responses to HIV-1. Cell Rep. 2016;16(6):1492–501.PubMedPubMedCentralCrossRef Maelfait J, Bridgeman A, Benlahrech A, Cursi C, Rehwinkel J. Restriction by SAMHD1 limits cGAS/STING-dependent innate and adaptive immune responses to HIV-1. Cell Rep. 2016;16(6):1492–501.PubMedPubMedCentralCrossRef
49.
go back to reference Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) Method. Methods. 2001;25(4):402–8.CrossRefPubMed Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) Method. Methods. 2001;25(4):402–8.CrossRefPubMed
Metadata
Title
STING and cGAS gene expressions were downregulated among HIV-1-infected persons after antiretroviral therapy
Authors
Lorena Leticia Peixoto de Lima
Allysson Quintino Tenório de Oliveira
Tuane Carolina Ferreira Moura
Ednelza da Silva Graça Amoras
Sandra Souza Lima
Andrea Nazaré Monteiro Rangel da Silva
Maria Alice Freitas Queiroz
Izaura Maria Vieira Cayres-Vallinoto
Ricardo Ishak
Antonio Carlos Rosário Vallinoto
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Virology Journal / Issue 1/2021
Electronic ISSN: 1743-422X
DOI
https://doi.org/10.1186/s12985-021-01548-6

Other articles of this Issue 1/2021

Virology Journal 1/2021 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.