Skip to main content
Top
Published in: Journal of Gastroenterology 11/2013

01-11-2013 | Original Article—Liver, Pancreas, and Biliary Tract

Dental infection of Porphyromonas gingivalis exacerbates high fat diet-induced steatohepatitis in mice

Authors: Hisako Furusho, Mutsumi Miyauchi, Hideyuki Hyogo, Toshihiro Inubushi, Min Ao, Kazuhisa Ouhara, Junzou Hisatune, Hidemi Kurihara, Motoyuki Sugai, C. Nelson Hayes, Takashi Nakahara, Hiroshi Aikata, Shoichi Takahashi, Kazuaki Chayama, Takashi Takata

Published in: Journal of Gastroenterology | Issue 11/2013

Login to get access

Abstract

Background

We investigated the effects of dental infection with Porphyromonas gingivalis (P.g.), an important periodontal pathogen, on NASH progression, by feeding mice a high fat diet (HFD)and examining P.g. infection in the liver of NASH patients.

Methods

C57BL/6J mice were fed either chow-diet (CD) or HFD for 12 weeks, and then half of the mice in each group were infected with P.g. from the pulp chamber (HFD-P.g.(−), HFD-P.g.(+), CD-P.g.(−) and CD-P.g.(+)). Histological and immunohistochemical examinations, measurement of serum lipopolysaccharide (LPS) levels and ELISA for cytokines in the liver were performed. We then studied the effects of LPS from P.g. (P.g.-LPS) on palmitate-induced steatotic hepatocytes in vitro, and performed immunohistochemical detection of P.g. in liver biopsy specimens of NASH patients.

Results

Serum levels of LPS are upregulated in P.g.(+) groups. Steatosis of the liver developed in HFD groups, and foci of Mac2-positive macrophages were prominent in HFD-P.g.(+). P.g. was detected in Kupffer cells and hepatocytes. Interestingly, areas of fibrosis with proliferation of hepatic stellate cells and collagen formation were only observed in HFD-P.g.(+). In steatotic hepatocytes, expression of TLR2, one of the P.g.-LPS receptors, was upregulated. P.g.-LPS further increased mRNA levels of palmitate-induced inflammasome and proinflammatory cytokines in steatotic hepatocytes. We demonstrated for the first time that P.g. existed in the liver of NASH patients with advanced fibrosis.

Conclusions

Dental infection of P.g. may play an important role in NASH progression through upregulation of the P.g.-LPS-TLR2 pathway and activation of inflammasomes. Therefore, preventing and/or eliminating P.g. infection by dental therapy may have a beneficial impact on management of NASH.
Literature
2.
go back to reference Malaguarnera M, Rosa MD, Nicoletti F, Malaguarnera L. Molecular mechanisms involved in NAFLD progression. J Mol Med. 2009;87:679–95.CrossRefPubMed Malaguarnera M, Rosa MD, Nicoletti F, Malaguarnera L. Molecular mechanisms involved in NAFLD progression. J Mol Med. 2009;87:679–95.CrossRefPubMed
3.
go back to reference Kojima S, Watanabe N, Numata M, et al. Increase in the prevalence of fatty liver in Japan over the past 12 years: analysis of clinical background. J Gastroenterol. 2003;38:954–61.CrossRefPubMed Kojima S, Watanabe N, Numata M, et al. Increase in the prevalence of fatty liver in Japan over the past 12 years: analysis of clinical background. J Gastroenterol. 2003;38:954–61.CrossRefPubMed
4.
go back to reference Leite NC, Villela-Nogueira CA, Pannain VLN, Bottino AC, Resende GFM, Cardoso CRL, et al. Histopathological stages of nonalcoholic fatty liver disease: prevalences and correlated factors. Liver Int. 2011;31(5):700–6.CrossRefPubMed Leite NC, Villela-Nogueira CA, Pannain VLN, Bottino AC, Resende GFM, Cardoso CRL, et al. Histopathological stages of nonalcoholic fatty liver disease: prevalences and correlated factors. Liver Int. 2011;31(5):700–6.CrossRefPubMed
5.
go back to reference Tannapfel A, Denk H, Dines H-P, Langer C, Schirmacher P, Trauner M, et al. Histopathological diagnosis of nonalcoholic and alcoholic fatty liver disease. Virchows Arch. 2011;458:511–23.CrossRefPubMed Tannapfel A, Denk H, Dines H-P, Langer C, Schirmacher P, Trauner M, et al. Histopathological diagnosis of nonalcoholic and alcoholic fatty liver disease. Virchows Arch. 2011;458:511–23.CrossRefPubMed
6.
go back to reference Day CP, Jamcs O. Steatohepatitis: a talc of two “hits”? Gastroenterology. 1988;114:842–5.CrossRef Day CP, Jamcs O. Steatohepatitis: a talc of two “hits”? Gastroenterology. 1988;114:842–5.CrossRef
7.
8.
go back to reference Sakaguchi S, Takahashi S, Sasaki T, Kumagai T, Nagata K. Progression of alcoholic and non-alcoholic steatohepatitis: common metabolic aspects of innate immune system and oxidative stress. Drug Metab Pharmacokinet. 2011;26(1):30–46.CrossRefPubMed Sakaguchi S, Takahashi S, Sasaki T, Kumagai T, Nagata K. Progression of alcoholic and non-alcoholic steatohepatitis: common metabolic aspects of innate immune system and oxidative stress. Drug Metab Pharmacokinet. 2011;26(1):30–46.CrossRefPubMed
9.
go back to reference Guo J, Friedman SL. Toll-like receptor 4 signaling in liver injury and hepatic fibrogenesis. Fibrogenesis Tissue Repair. 2010;3:21.CrossRefPubMed Guo J, Friedman SL. Toll-like receptor 4 signaling in liver injury and hepatic fibrogenesis. Fibrogenesis Tissue Repair. 2010;3:21.CrossRefPubMed
10.
go back to reference Gabele E, Dostert K, Patsenker E, Stickel F, Hellerbrand C. A new model of interactive effects of alcohol and high-fat diet on hepatic fibrosis. Alchohorism Clin Extern Res. 2011;35(7):1361–7.CrossRef Gabele E, Dostert K, Patsenker E, Stickel F, Hellerbrand C. A new model of interactive effects of alcohol and high-fat diet on hepatic fibrosis. Alchohorism Clin Extern Res. 2011;35(7):1361–7.CrossRef
11.
go back to reference Wigg AJ, Roberts-Thomson IC, Dymock PB, McCharthy PJ, Grose RH, Cummins AG. The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxemia, and tumor necrosis factor alpha in the pathogenesis of nonalcoholic steatohepatitis. Gut. 2001;48:206–11.CrossRefPubMed Wigg AJ, Roberts-Thomson IC, Dymock PB, McCharthy PJ, Grose RH, Cummins AG. The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxemia, and tumor necrosis factor alpha in the pathogenesis of nonalcoholic steatohepatitis. Gut. 2001;48:206–11.CrossRefPubMed
12.
go back to reference Farhadi A, Gundlapalli S, Shaikh M, Frantzides C, Harrell L, Kwasny MM, et al. Susceptibility to gut leakiness: a possible mechanism for endotoxaemia in non-alcoholic steatohepatitis. Liver Int. 2008;28(7):1026–33.CrossRefPubMed Farhadi A, Gundlapalli S, Shaikh M, Frantzides C, Harrell L, Kwasny MM, et al. Susceptibility to gut leakiness: a possible mechanism for endotoxaemia in non-alcoholic steatohepatitis. Liver Int. 2008;28(7):1026–33.CrossRefPubMed
13.
go back to reference Saito D, Coutinbo LL, Saito CPB, Tsai SM, Hoflinf JF, Goncalves RB. Real-time polymerase chain reaction quantification of Porphyromonas gingivalis and Tannerella forsythia in primary endodontic infections. J Endod. 2009;35:1518–24.CrossRefPubMed Saito D, Coutinbo LL, Saito CPB, Tsai SM, Hoflinf JF, Goncalves RB. Real-time polymerase chain reaction quantification of Porphyromonas gingivalis and Tannerella forsythia in primary endodontic infections. J Endod. 2009;35:1518–24.CrossRefPubMed
14.
go back to reference Pereira CV, Stipp RN, Fonseca DC, Pereira LJ, Hofling JF. Detection and clonal analysis of anaerobic bacteria associated to endodontic-periodontal lesions. J Periodontol. 2011;82(12):1767–75.CrossRefPubMed Pereira CV, Stipp RN, Fonseca DC, Pereira LJ, Hofling JF. Detection and clonal analysis of anaerobic bacteria associated to endodontic-periodontal lesions. J Periodontol. 2011;82(12):1767–75.CrossRefPubMed
15.
go back to reference Seymour GJ, Ford PJ, Cullinan MP, Leishman S, Yamazaki K. Relationship between periodontal infections and systemic disease. Clin Microbiol Infect. 2007;13(Suppl 4):3–10.PubMedCrossRef Seymour GJ, Ford PJ, Cullinan MP, Leishman S, Yamazaki K. Relationship between periodontal infections and systemic disease. Clin Microbiol Infect. 2007;13(Suppl 4):3–10.PubMedCrossRef
16.
go back to reference Pizzo G, Guiglia R, Russo LL, Campisi G. Dentistry and internal medicine: from the focal infection theory to the periodontal medicine concept. Europ J Intern Med. 2011;21:496–502.CrossRef Pizzo G, Guiglia R, Russo LL, Campisi G. Dentistry and internal medicine: from the focal infection theory to the periodontal medicine concept. Europ J Intern Med. 2011;21:496–502.CrossRef
17.
go back to reference Wada K, Kamisaki Y. Roles of oral bacteria in cardiovascular diseases—from molecular mechanisms to clinical cases: involvement of Porphyromonas gingivalis in the development of human aortic aneurysm. J Pharmacol Sci. 2010;113:115–9.CrossRefPubMed Wada K, Kamisaki Y. Roles of oral bacteria in cardiovascular diseases—from molecular mechanisms to clinical cases: involvement of Porphyromonas gingivalis in the development of human aortic aneurysm. J Pharmacol Sci. 2010;113:115–9.CrossRefPubMed
18.
go back to reference Figuero E, Sanchez-Beltran M, Cuesta-Frecheso S, Tejerina JM, del Castro JA, Gutierrez JM, et al. Detection of periodontal bacteria in atheromatous plaques by nested polymerase chain reaction. J Periodontol. 2011;82(10):1469–77.CrossRefPubMed Figuero E, Sanchez-Beltran M, Cuesta-Frecheso S, Tejerina JM, del Castro JA, Gutierrez JM, et al. Detection of periodontal bacteria in atheromatous plaques by nested polymerase chain reaction. J Periodontol. 2011;82(10):1469–77.CrossRefPubMed
19.
go back to reference Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander-Tetri BA, Bacon BR. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999;94(9):2467–74.CrossRefPubMed Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander-Tetri BA, Bacon BR. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999;94(9):2467–74.CrossRefPubMed
20.
go back to reference Yoshimura M, Nakano Y, Yamashita Y, Oho T, Saito T, Koga T. Formation of methyl mercaptan from l-methionine by Porphyromonas gingivalis. Infect Immun. 2000;68(12):6912–6.CrossRefPubMed Yoshimura M, Nakano Y, Yamashita Y, Oho T, Saito T, Koga T. Formation of methyl mercaptan from l-methionine by Porphyromonas gingivalis. Infect Immun. 2000;68(12):6912–6.CrossRefPubMed
21.
go back to reference Kawai T, Paster BJ, Komatsuzawa H, Ernst CW, Goncalves RB, Sasaki H, et al. Cross-reactive adaptive immune response to oral commensal bacteria results in an induction of receptor activator of nuclear factor-kappaB ligand (RANKL)-dependent periodontal bone resorption in a mouse model. Oral Microbiol Immunol. 2007;22(3):208–15. Kawai T, Paster BJ, Komatsuzawa H, Ernst CW, Goncalves RB, Sasaki H, et al. Cross-reactive adaptive immune response to oral commensal bacteria results in an induction of receptor activator of nuclear factor-kappaB ligand (RANKL)-dependent periodontal bone resorption in a mouse model. Oral Microbiol Immunol. 2007;22(3):208–15.
22.
go back to reference Waki K, Anno K, Ono T, Ide T, Chayama K, Tahara H. Establishment of functional telomerase immortalized human hepatocytes and a hepatic stellate cell line for telomere-targeting anticancer drug development. Cancer Sci. 2010;101:1678–85.CrossRefPubMed Waki K, Anno K, Ono T, Ide T, Chayama K, Tahara H. Establishment of functional telomerase immortalized human hepatocytes and a hepatic stellate cell line for telomere-targeting anticancer drug development. Cancer Sci. 2010;101:1678–85.CrossRefPubMed
23.
go back to reference Wobser H, Dorn C, Weiss TS, Amann T, Bollheimer C, Büttner R, et al. Lipid accumulation in hepatocytes induces fibrogenic activation of hepatic stellate cells. Cell Res. 2009;19:996–1005.CrossRefPubMed Wobser H, Dorn C, Weiss TS, Amann T, Bollheimer C, Büttner R, et al. Lipid accumulation in hepatocytes induces fibrogenic activation of hepatic stellate cells. Cell Res. 2009;19:996–1005.CrossRefPubMed
24.
go back to reference Csak T, Velayudham A, Hritz I, Petrasek J, Levin I, Lippai D, et al. Deficiency in myeloid differentiation factor-2 and toll-like receptor 4 expression attenuates nonalcoholic steatohepatitis and fibrosis in mice. Am J Physiol Gastrointest Liver Physiol. 2011;300:G433–41.CrossRefPubMed Csak T, Velayudham A, Hritz I, Petrasek J, Levin I, Lippai D, et al. Deficiency in myeloid differentiation factor-2 and toll-like receptor 4 expression attenuates nonalcoholic steatohepatitis and fibrosis in mice. Am J Physiol Gastrointest Liver Physiol. 2011;300:G433–41.CrossRefPubMed
25.
go back to reference Aoyama T, Paik Y-H, Seki E. Toll-like receptor signaling and liver fibrosis. Gastroenterology Res Pract 2010; pii:192543. Epub 2010 Jul 25. Aoyama T, Paik Y-H, Seki E. Toll-like receptor signaling and liver fibrosis. Gastroenterology Res Pract 2010; pii:192543. Epub 2010 Jul 25.
26.
go back to reference Gentile CL, Pagliassotti MJ. The role of fatty acids in the development and progression of nonalcoholic fatty liver disease. J Nutr Biochem. 2008;19:567–76.CrossRefPubMed Gentile CL, Pagliassotti MJ. The role of fatty acids in the development and progression of nonalcoholic fatty liver disease. J Nutr Biochem. 2008;19:567–76.CrossRefPubMed
27.
go back to reference Greenberg AS, Coleman RA, Kraemer FB, McManaman JL, Obin MS, Puri V, et al. The role of lipid droplets in metabolic disease in rodent and humans. J Clin Invest. 2011;121:2102–10.CrossRefPubMed Greenberg AS, Coleman RA, Kraemer FB, McManaman JL, Obin MS, Puri V, et al. The role of lipid droplets in metabolic disease in rodent and humans. J Clin Invest. 2011;121:2102–10.CrossRefPubMed
28.
go back to reference Darveau RP. Periodontitis: a polymicrobial disruption of host homeostasis. Nat Rev. 2010;8:481–90.CrossRef Darveau RP. Periodontitis: a polymicrobial disruption of host homeostasis. Nat Rev. 2010;8:481–90.CrossRef
29.
go back to reference Yoneda M, Naka S, Nakano K, Wada K, Endo H, Mawatari H, et al. Involvement of a periodontal pathogen, Porphyromonas gingivalis on the pathogenesis of non-alcoholic fatty liver disease. BMC Gastroenterol 2012;12(1):16. [Epub ahead of print]. Yoneda M, Naka S, Nakano K, Wada K, Endo H, Mawatari H, et al. Involvement of a periodontal pathogen, Porphyromonas gingivalis on the pathogenesis of non-alcoholic fatty liver disease. BMC Gastroenterol 2012;12(1):16. [Epub ahead of print].
30.
go back to reference Gibson FC 3rd, Hong C, Chou HH, Yumoto H, Chen J, Lien E, et al. Innate immune recognition of invasive bacteria accelerates atherosclerosis in apolipoprotein E-deficient mice. Circulation. 2004;109(22):2801–6.CrossRefPubMed Gibson FC 3rd, Hong C, Chou HH, Yumoto H, Chen J, Lien E, et al. Innate immune recognition of invasive bacteria accelerates atherosclerosis in apolipoprotein E-deficient mice. Circulation. 2004;109(22):2801–6.CrossRefPubMed
31.
go back to reference Boggess KA, Madianos PN, Preisser JS, Moise KJ, Offenbacher S. Chronic maternal and fetal Porphyromonas gingivalis exposure during pregnancy in rabbits. Am J Obstet Gynecol. 2005;192:554–7.CrossRefPubMed Boggess KA, Madianos PN, Preisser JS, Moise KJ, Offenbacher S. Chronic maternal and fetal Porphyromonas gingivalis exposure during pregnancy in rabbits. Am J Obstet Gynecol. 2005;192:554–7.CrossRefPubMed
32.
go back to reference Sundaresan S, Vijayagopal, Mills N, Prasad C. A mouse model for nonalcoholic steatohepatitis. J Nutrit Biochem. 2011;22:979–84.CrossRef Sundaresan S, Vijayagopal, Mills N, Prasad C. A mouse model for nonalcoholic steatohepatitis. J Nutrit Biochem. 2011;22:979–84.CrossRef
33.
go back to reference Rivera CA, Adegboyega P, van Rooijen N, Tagalicud A, Allman M, Wallace M, et al. Toll-like receptor-4 signaling and Kupffer cells play pivotal roles in the pathogenesis of non-alcoholic steatohepatitis. J Hepatol. 2007;47(4):571–9.CrossRefPubMed Rivera CA, Adegboyega P, van Rooijen N, Tagalicud A, Allman M, Wallace M, et al. Toll-like receptor-4 signaling and Kupffer cells play pivotal roles in the pathogenesis of non-alcoholic steatohepatitis. J Hepatol. 2007;47(4):571–9.CrossRefPubMed
34.
go back to reference Kocgozlu L, Elkaim R, Tenenbaum H, Werner S. Variable cell responses to P. gingivalis lipopolysaccharide. J Dent Res. 2009;88(8):741–5.CrossRefPubMed Kocgozlu L, Elkaim R, Tenenbaum H, Werner S. Variable cell responses to P. gingivalis lipopolysaccharide. J Dent Res. 2009;88(8):741–5.CrossRefPubMed
35.
go back to reference Puri P, Wiest MM, Cheung O, Mirshahi F, Sargeant C, Min HK, et al. The plasma lipidomic signature of nonalcoholic steatohepatitis. Hepatology. 2009;50(6):1827–38.CrossRefPubMed Puri P, Wiest MM, Cheung O, Mirshahi F, Sargeant C, Min HK, et al. The plasma lipidomic signature of nonalcoholic steatohepatitis. Hepatology. 2009;50(6):1827–38.CrossRefPubMed
36.
go back to reference Csak T, Ganz M, Pespisa J, Kodys K, Dolganiuc A, Szabo G. Fatty acid and endotoxin activate inflammasomes in mouse hepatocytes that release danger signals to stimulate immune cells. Hepatology. 2011;54(1):133–44.CrossRefPubMed Csak T, Ganz M, Pespisa J, Kodys K, Dolganiuc A, Szabo G. Fatty acid and endotoxin activate inflammasomes in mouse hepatocytes that release danger signals to stimulate immune cells. Hepatology. 2011;54(1):133–44.CrossRefPubMed
37.
go back to reference Xu ZJ, Fan JG, Ding XD, Qiao L, Wang GL. Characterization of high-fat, diet-induced, non-alcoholic steatohepatitis with fibrosis in rats. Dig Dis Sci. 2010;55(4):931–40.CrossRefPubMed Xu ZJ, Fan JG, Ding XD, Qiao L, Wang GL. Characterization of high-fat, diet-induced, non-alcoholic steatohepatitis with fibrosis in rats. Dig Dis Sci. 2010;55(4):931–40.CrossRefPubMed
38.
go back to reference Fan J, Frey RS, Malik AB. TLR4 signaling induces TLR2 expression in endothelial cells via neutrophil NADPH oxidase. J Clin Invest. 2003;112(8):1234–43.PubMed Fan J, Frey RS, Malik AB. TLR4 signaling induces TLR2 expression in endothelial cells via neutrophil NADPH oxidase. J Clin Invest. 2003;112(8):1234–43.PubMed
39.
go back to reference Shi H, Kokoeva MV, Inouye K, Tzameli I, Yin H, Flier JS. TLR4 links innate immunity and fatty acid-induced insulin resistance. J Clin Invest. 2006;116(11):3015–25.CrossRefPubMed Shi H, Kokoeva MV, Inouye K, Tzameli I, Yin H, Flier JS. TLR4 links innate immunity and fatty acid-induced insulin resistance. J Clin Invest. 2006;116(11):3015–25.CrossRefPubMed
40.
go back to reference Vandanmagsar B, Youm YH, Ravussin A, Galgani JE, Stadler K, Mynatt RL, et al. The NLRP3 inflammasome instigates obesity-induced inflammation and insulin resistance. Nat Med. 2011;17(2):179–88.CrossRefPubMed Vandanmagsar B, Youm YH, Ravussin A, Galgani JE, Stadler K, Mynatt RL, et al. The NLRP3 inflammasome instigates obesity-induced inflammation and insulin resistance. Nat Med. 2011;17(2):179–88.CrossRefPubMed
41.
go back to reference Wen H, Gris D, Lei Y, Jha S, Zhang L, Huang MT, et al. Fatty acid-induced NLRP3-ASC inflammasome activation interferes with insulin signaling. Nat Immunol. 2011;12(5):408–15.CrossRefPubMed Wen H, Gris D, Lei Y, Jha S, Zhang L, Huang MT, et al. Fatty acid-induced NLRP3-ASC inflammasome activation interferes with insulin signaling. Nat Immunol. 2011;12(5):408–15.CrossRefPubMed
42.
go back to reference Albandar JM. Epidemiology and risk factors of periodontal diseases. Dent Clin North Am. 2005;49(3):517–32.CrossRefPubMed Albandar JM. Epidemiology and risk factors of periodontal diseases. Dent Clin North Am. 2005;49(3):517–32.CrossRefPubMed
Metadata
Title
Dental infection of Porphyromonas gingivalis exacerbates high fat diet-induced steatohepatitis in mice
Authors
Hisako Furusho
Mutsumi Miyauchi
Hideyuki Hyogo
Toshihiro Inubushi
Min Ao
Kazuhisa Ouhara
Junzou Hisatune
Hidemi Kurihara
Motoyuki Sugai
C. Nelson Hayes
Takashi Nakahara
Hiroshi Aikata
Shoichi Takahashi
Kazuaki Chayama
Takashi Takata
Publication date
01-11-2013
Publisher
Springer Japan
Published in
Journal of Gastroenterology / Issue 11/2013
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-012-0738-1

Other articles of this Issue 11/2013

Journal of Gastroenterology 11/2013 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.