Skip to main content
Top
Published in: Journal of Bone and Mineral Metabolism 6/2019

01-11-2019 | Lactation | Original Article

Maternal 25-hydroxycholecalciferol during lactation improves intestinal calcium absorption and bone properties in sow-suckling piglet pairs

Authors: Lianhua Zhang, Jiangxu Hu, Miao Li, Qinghui Shang, Sujie Liu, Xiangshu Piao

Published in: Journal of Bone and Mineral Metabolism | Issue 6/2019

Login to get access

Abstract

Lower maternal vitamin D status during lactation is a common health problem. The objectives of this study were to investigate the effects of maternal 25-hydroxycholecalciferol (25-OH-D3) supplementation during lactation on maternal and neonatal bone health in a sow model. 32 Large White × Landrace sows were assigned randomly to one of two diets supplemented with 2000 IU/kg vitamin D3 (ND) or 50 μg/kg 25-OH-D3 (25-D). The experiment began on day 107 of gestation and continued until weaning on day 21 of lactation. Maternal 25-OH-D3 supplementation significantly decreased milk n-6:n-3 PUFA ratio, which supported bone formation of piglets. Supplementation with 25-OH-D3 altered bone turnover rate of sows and piglets, as evidenced by higher bone-specific alkaline phosphatase (BALP) concentration in serum. 25-D sows had significantly higher bone density and mechanical properties of tibias and femurs than ND sows. Calcium (Ca) absorption rate was higher in 25-D sows than ND sows, which was caused partially by the increased mRNA expressions of renal 1α-hydroxylase (CYP27B1) and duodenal vitamin D receptor (VDR), transient receptor potential vanilloid 6 (TRPV6), and calcium-binding protein D9k (CaBP-D9k). Maternal 25-OH-D3 supplementation increased tibial and femoral Ca content by up-regulating Ca-related gene expression in kidney (CYP27B1), ileum (VDR and claudin-2), and colon (VDR and CaBP-D9k), thus, activating 1,25-dihydroxyvitamin D3 [1,25-(OH)2-D3]-dependent Ca transport in piglets. In conclusion, improved milk fatty acids and higher mRNA expressions of calcitropic genes triggered by maternal 25-OH-D3 supplementation would be the potential mechanism underlying the positive effects of 25-OH-D3 on maternal and neonatal bone health.
Appendix
Available only for authorised users
Literature
1.
go back to reference Park JW, Lee JH, Kim SW, Han JS, Kang KS, Kim SJ, Park TS (2018) Muscle differentiation induced up-regulation of calcium-related gene expression in quail myoblasts. Asian-Australas J Anim Sci 31:1507–1515PubMedPubMedCentral Park JW, Lee JH, Kim SW, Han JS, Kang KS, Kim SJ, Park TS (2018) Muscle differentiation induced up-regulation of calcium-related gene expression in quail myoblasts. Asian-Australas J Anim Sci 31:1507–1515PubMedPubMedCentral
2.
go back to reference Brun LR, Lombarte M, Roma S, Perez F, Millán JL, Rigalli A (2018) Increased calcium uptake and improved trabecular bone properties in intestinal alkaline phosphatase knockout mice. J Bone Miner Metab 36:661–667PubMed Brun LR, Lombarte M, Roma S, Perez F, Millán JL, Rigalli A (2018) Increased calcium uptake and improved trabecular bone properties in intestinal alkaline phosphatase knockout mice. J Bone Miner Metab 36:661–667PubMed
3.
go back to reference Kovacs CS (2016) Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol Rev 96:449–547PubMed Kovacs CS (2016) Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol Rev 96:449–547PubMed
4.
go back to reference Halloran BP, Barthell E, DeLuca HF (1979) Vitamin D metabolism during pregnancy and lactation in the rat. Proc Natl Acad Sci 76:5549–5553PubMed Halloran BP, Barthell E, DeLuca HF (1979) Vitamin D metabolism during pregnancy and lactation in the rat. Proc Natl Acad Sci 76:5549–5553PubMed
5.
go back to reference Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE (1995) Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 61:514–523PubMed Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE (1995) Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 61:514–523PubMed
6.
go back to reference Costa ML, Krupa FG, Rehder PM, Sousa MH, Costa-Paiva L, Cecatti JG (2012) Forearm bone mineral density changes during postpartum and the effects of breastfeeding, amenorrhea, body mass index and contraceptive use. Osteoporos Int 23:1691–1698PubMed Costa ML, Krupa FG, Rehder PM, Sousa MH, Costa-Paiva L, Cecatti JG (2012) Forearm bone mineral density changes during postpartum and the effects of breastfeeding, amenorrhea, body mass index and contraceptive use. Osteoporos Int 23:1691–1698PubMed
7.
go back to reference Kalkwarf HJ, Specker BL, Bianchi DC, Ranz J, Ho M (1997) The effect of calcium supplementation on bone density during lactation and after weaning. N Engl J Med 21:523–528 Kalkwarf HJ, Specker BL, Bianchi DC, Ranz J, Ho M (1997) The effect of calcium supplementation on bone density during lactation and after weaning. N Engl J Med 21:523–528
8.
go back to reference Choi SW, Kweon SS, Choi JS, Rhee JA, Lee YH, Nam HS, Jeong SK, Park KS, Ryu SY, Song HR, Shin MH (2016) The association between vitamin D and parathyroid hormone and bone mineral density: the Dong-gu Study. J Bone Miner Metab 34:555–563PubMed Choi SW, Kweon SS, Choi JS, Rhee JA, Lee YH, Nam HS, Jeong SK, Park KS, Ryu SY, Song HR, Shin MH (2016) The association between vitamin D and parathyroid hormone and bone mineral density: the Dong-gu Study. J Bone Miner Metab 34:555–563PubMed
9.
go back to reference Jakobsen J, Maribo H, Bysted A, Sommer HM, Hels O (2007) 25-hydroxyvitamin D3 affects vitamin D status similar to vitamin D3 in pigs–but the meat produced has a lower content of vitamin D. Br J Nutr 98:908–913PubMed Jakobsen J, Maribo H, Bysted A, Sommer HM, Hels O (2007) 25-hydroxyvitamin D3 affects vitamin D status similar to vitamin D3 in pigs–but the meat produced has a lower content of vitamin D. Br J Nutr 98:908–913PubMed
10.
go back to reference Kimball S, Gel-H Fuleihan, Vieth R (2008) Vitamin D: a growing perspective. Crit Rev Clin Lab Sci 45:339–414PubMed Kimball S, Gel-H Fuleihan, Vieth R (2008) Vitamin D: a growing perspective. Crit Rev Clin Lab Sci 45:339–414PubMed
11.
go back to reference Pilz S, Zittermann A, Obeid R, Hahn A, Pludowski P, Trummer C, Lerchbaum E, Pérez-López FR, Karras SN, März W (2018) The role of vitamin D in fertility and during pregnancy and lactation: a review of clinical data. Int J Environ Res Public Health 15:2241PubMedCentral Pilz S, Zittermann A, Obeid R, Hahn A, Pludowski P, Trummer C, Lerchbaum E, Pérez-López FR, Karras SN, März W (2018) The role of vitamin D in fertility and during pregnancy and lactation: a review of clinical data. Int J Environ Res Public Health 15:2241PubMedCentral
12.
go back to reference Zinser GM, Welsh J (2004) Accelerated mammary gland development during pregnancy and delayed postlactational involution in vitamin D3 receptor null mice. Mol Endocrinol 18:2208–2223PubMed Zinser GM, Welsh J (2004) Accelerated mammary gland development during pregnancy and delayed postlactational involution in vitamin D3 receptor null mice. Mol Endocrinol 18:2208–2223PubMed
13.
go back to reference Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, Shoenfeld Y, Lerchbaum E, Llewellyn DJ, Kienreich K, Soni M (2013) Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev 12:976–989PubMed Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, Shoenfeld Y, Lerchbaum E, Llewellyn DJ, Kienreich K, Soni M (2013) Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev 12:976–989PubMed
14.
go back to reference Cashman KD, Seamans KM, Lucey AJ, Stöcklin E, Weber P, Kiely M, Hill TR (2012) Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults. Am J Clin Nutr 95:1350–1356PubMed Cashman KD, Seamans KM, Lucey AJ, Stöcklin E, Weber P, Kiely M, Hill TR (2012) Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults. Am J Clin Nutr 95:1350–1356PubMed
15.
go back to reference National Research Council (2012) Nutrient requirements of swine. National Academy Press, Washington, DC National Research Council (2012) Nutrient requirements of swine. National Academy Press, Washington, DC
16.
go back to reference Xu Y, Zeng Z, Xu X, Tian Q, Ma X, Long S, Piao M, Cheng Z, Piao X (2017) Effects of the standardized ileal digestible valine:lysine ratio on performance, milk composition and plasma indices of lactating sows. Anim Sci J 88:1082–1092PubMed Xu Y, Zeng Z, Xu X, Tian Q, Ma X, Long S, Piao M, Cheng Z, Piao X (2017) Effects of the standardized ileal digestible valine:lysine ratio on performance, milk composition and plasma indices of lactating sows. Anim Sci J 88:1082–1092PubMed
17.
go back to reference Gomes FP, Shaw PN, Whitfield K, Hewavitharana AK (2015) Simultaneous quantitative analysis of eight vitamin D analogues in milk using liquid chromatography-tandem mass spectrometry. Anal Chim Acta 891:211–220PubMed Gomes FP, Shaw PN, Whitfield K, Hewavitharana AK (2015) Simultaneous quantitative analysis of eight vitamin D analogues in milk using liquid chromatography-tandem mass spectrometry. Anal Chim Acta 891:211–220PubMed
18.
go back to reference Jang YD, Lindemann MD, Agudelo-Trujillo JH, Escobar CS, Kerr BJ, Inocencio N, Cromwell GL (2014) Comparison of direct and indirect estimates of apparent total tract digestibility in swine with effort to reduce variation by pooling of multiple day fecal samples. J Anim Sci 92:4566–4576PubMed Jang YD, Lindemann MD, Agudelo-Trujillo JH, Escobar CS, Kerr BJ, Inocencio N, Cromwell GL (2014) Comparison of direct and indirect estimates of apparent total tract digestibility in swine with effort to reduce variation by pooling of multiple day fecal samples. J Anim Sci 92:4566–4576PubMed
19.
go back to reference Association of Official Analytical Chemists (2006) Official methods of analysis. AOAC Int, Gaithersgurg, VA Association of Official Analytical Chemists (2006) Official methods of analysis. AOAC Int, Gaithersgurg, VA
20.
go back to reference Keenan MJ, Hegsted M, Jones KL, Delany JP, Kime JC, Melancon LE, Tulley RT, Hong KD (1997) Comparison of bone density measurement techniques: DXA and Archimedes’ principle. J Bone Miner Res 12:1903–1907PubMed Keenan MJ, Hegsted M, Jones KL, Delany JP, Kime JC, Melancon LE, Tulley RT, Hong KD (1997) Comparison of bone density measurement techniques: DXA and Archimedes’ principle. J Bone Miner Res 12:1903–1907PubMed
21.
go back to reference Flohr JR, Tokach MD, Dritz SS, DeRouchey JM, Goodband RD, Nelssen JL, Bergstrom JR (2014) An evaluation of the effects of added vitamin D3 in maternal diets on sow and pig performance. J Anim Sci 92:594–603PubMed Flohr JR, Tokach MD, Dritz SS, DeRouchey JM, Goodband RD, Nelssen JL, Bergstrom JR (2014) An evaluation of the effects of added vitamin D3 in maternal diets on sow and pig performance. J Anim Sci 92:594–603PubMed
22.
go back to reference Livak KJ, Schmittgen TD (2001) Analysis of relative gene expression data using real-time quantitative PCR and the 2−ΔΔCT method. Methods 25:402–408 Livak KJ, Schmittgen TD (2001) Analysis of relative gene expression data using real-time quantitative PCR and the 2−ΔΔCT method. Methods 25:402–408
23.
go back to reference Swindle MM, Makin A, Herron AJ, Clubb FJ Jr, Frazier KS (2012) Swine as models in biomedical research and toxicology testing. Vet Pathol 49:344–356PubMed Swindle MM, Makin A, Herron AJ, Clubb FJ Jr, Frazier KS (2012) Swine as models in biomedical research and toxicology testing. Vet Pathol 49:344–356PubMed
24.
go back to reference Lauridsen C, Halekoh U, Larsen T, Jensen SK (2010) Reproductive performance and bone status markers of gilts and lactating sows supplemented with two different forms of vitamin D. J Anim Sci 88:202–213PubMed Lauridsen C, Halekoh U, Larsen T, Jensen SK (2010) Reproductive performance and bone status markers of gilts and lactating sows supplemented with two different forms of vitamin D. J Anim Sci 88:202–213PubMed
25.
go back to reference Goff JP, Horst RL, Littledike ET (1984) Effect of sow vitamin D status at parturition on the vitamin D status of neonatal piglets. J Nutr 114:163–169PubMed Goff JP, Horst RL, Littledike ET (1984) Effect of sow vitamin D status at parturition on the vitamin D status of neonatal piglets. J Nutr 114:163–169PubMed
26.
go back to reference Hollis BW, Wagner CL (2004) Assessment of dietary vitamin D requirements during pregnancy and lactation. Am J Clin Nutr 79:717–726PubMed Hollis BW, Wagner CL (2004) Assessment of dietary vitamin D requirements during pregnancy and lactation. Am J Clin Nutr 79:717–726PubMed
27.
go back to reference Specker BL, Tsang RC, Hollis BW (1985) Effect of race and diet on human-milk vitamin D and 25-hydroxyvitamin D. Am J Dis Child 139:1134–1137PubMed Specker BL, Tsang RC, Hollis BW (1985) Effect of race and diet on human-milk vitamin D and 25-hydroxyvitamin D. Am J Dis Child 139:1134–1137PubMed
28.
go back to reference Weber GM, Witschi AK, Wenk C, Martens H (2014) Effects of dietary 25-hydroxycholecalciferol and cholecalciferol on blood vitamin D and mineral status, bone turnover, milk composition, and reproductive performance of sows. J Anim Sci 92:899–909PubMed Weber GM, Witschi AK, Wenk C, Martens H (2014) Effects of dietary 25-hydroxycholecalciferol and cholecalciferol on blood vitamin D and mineral status, bone turnover, milk composition, and reproductive performance of sows. J Anim Sci 92:899–909PubMed
29.
go back to reference Li Y, Seifert MF, Ney DM, Grahn M, Grant AL, Allen KG, Watkins BA (1999) Dietary conjugated linoleic acids alter serum IGF-I and IGF binding protein concentrations and reduce bone formation in rats fed (n-6) or (n-3) fatty acids. J Bone Miner Res 14:1153–1162PubMed Li Y, Seifert MF, Ney DM, Grahn M, Grant AL, Allen KG, Watkins BA (1999) Dietary conjugated linoleic acids alter serum IGF-I and IGF binding protein concentrations and reduce bone formation in rats fed (n-6) or (n-3) fatty acids. J Bone Miner Res 14:1153–1162PubMed
30.
go back to reference Korotkova M, Ohlsson C, Hanson LA, Strandvik B (2004) Dietary n-6:n-3 fatty acid ratio in the perinatal period affects bone parameters in adult female rats. Br J Nutr 92:643–648PubMed Korotkova M, Ohlsson C, Hanson LA, Strandvik B (2004) Dietary n-6:n-3 fatty acid ratio in the perinatal period affects bone parameters in adult female rats. Br J Nutr 92:643–648PubMed
31.
go back to reference Watkins BA, Li Y, Allen KG, Hoffmann WE, Seifert MF (2000) Dietary ratio of (n-6)/(n-3) polyunsaturated fatty acids alters the fatty acid composition of bone compartments and biomarkers of bone formation in rats. J Nutr 130:2274–2284PubMed Watkins BA, Li Y, Allen KG, Hoffmann WE, Seifert MF (2000) Dietary ratio of (n-6)/(n-3) polyunsaturated fatty acids alters the fatty acid composition of bone compartments and biomarkers of bone formation in rats. J Nutr 130:2274–2284PubMed
32.
go back to reference Zinser GM, Welsh J (2004) Accelerated mammary gland development during pregnancy and delayed postlactational involution in vitamin D3 receptor null mice. Mol Endocrinol 18:2208–2223PubMed Zinser GM, Welsh J (2004) Accelerated mammary gland development during pregnancy and delayed postlactational involution in vitamin D3 receptor null mice. Mol Endocrinol 18:2208–2223PubMed
33.
go back to reference Allen JC (1984) Effect of vitamin D deficiency on mouse mammary gland and milk. J Nutr 114:42–49PubMed Allen JC (1984) Effect of vitamin D deficiency on mouse mammary gland and milk. J Nutr 114:42–49PubMed
34.
go back to reference Kang EJ, Lee JE, An SM, Lee JH, Kwon HS, Kim BC, Kim SJ, Kim JM, Hwang DY, Jung YJ, Yang SY, Kim SC, An BS (2015) The effects of vitamin D3 on lipogenesis in the liver and adipose tissue of pregnant rats. Int J Mol Med 36:1151–1158PubMed Kang EJ, Lee JE, An SM, Lee JH, Kwon HS, Kim BC, Kim SJ, Kim JM, Hwang DY, Jung YJ, Yang SY, Kim SC, An BS (2015) The effects of vitamin D3 on lipogenesis in the liver and adipose tissue of pregnant rats. Int J Mol Med 36:1151–1158PubMed
35.
go back to reference Ji L, Gupta M, Feldman BJ (2016) Vitamin D regulates fatty acid composition in subcutaneous adipose tissue through Elovl3. Endocrinology 157:91–97PubMed Ji L, Gupta M, Feldman BJ (2016) Vitamin D regulates fatty acid composition in subcutaneous adipose tissue through Elovl3. Endocrinology 157:91–97PubMed
36.
go back to reference Ram VS, Parthiban Sudhakar U, Mithradas N, Prabhakar R (2015) Bone biomarkers in periodontal disease: a review article. J Clin Diagn Res 9:ZE07–10PubMedPubMedCentral Ram VS, Parthiban Sudhakar U, Mithradas N, Prabhakar R (2015) Bone biomarkers in periodontal disease: a review article. J Clin Diagn Res 9:ZE07–10PubMedPubMedCentral
37.
go back to reference Harada K, Itoh H, Kawazoe Y, Miyazaki S, Doi K, Kubo T, Akagawa Y, Shiba T (2013) Polyphosphate-mediated inhibition of tartrate-resistant acid phosphatase and suppression of bone resorption of osteoclasts. PLoS One 8:e78612PubMedPubMedCentral Harada K, Itoh H, Kawazoe Y, Miyazaki S, Doi K, Kubo T, Akagawa Y, Shiba T (2013) Polyphosphate-mediated inhibition of tartrate-resistant acid phosphatase and suppression of bone resorption of osteoclasts. PLoS One 8:e78612PubMedPubMedCentral
38.
go back to reference Bogazzi F, Rossi G, Lombardi M, Tomisti L, Sardella C, Manetti L, Curzio O, Marcocci C, Grasso L, Gasperi M, Martino E (2011) Vitamin D status may contribute to serum insulin-like growth factor I concentrations in healthy subjects. J Endocrinol Invest 34:e200–e203PubMed Bogazzi F, Rossi G, Lombardi M, Tomisti L, Sardella C, Manetti L, Curzio O, Marcocci C, Grasso L, Gasperi M, Martino E (2011) Vitamin D status may contribute to serum insulin-like growth factor I concentrations in healthy subjects. J Endocrinol Invest 34:e200–e203PubMed
39.
go back to reference Ohlsson C, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC (1998) Growth hormone and bone. Endocr Rev 19:55–79PubMed Ohlsson C, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC (1998) Growth hormone and bone. Endocr Rev 19:55–79PubMed
40.
go back to reference Haussler MR, Whitfield GK, Kaneko I, Haussler CA, Hsieh D, Hsieh JC, Jurutka PW (2013) Molecular mechanisms of vitamin D action. Calcif Tissue Int 92:77–98PubMed Haussler MR, Whitfield GK, Kaneko I, Haussler CA, Hsieh D, Hsieh JC, Jurutka PW (2013) Molecular mechanisms of vitamin D action. Calcif Tissue Int 92:77–98PubMed
41.
go back to reference Christakos S, Dhawan P, Porta A, Mady LJ, Seth T (2011) Vitamin D and intestinal calcium absorption. Mol Cell Endocrinol 347:25–29PubMedPubMedCentral Christakos S, Dhawan P, Porta A, Mady LJ, Seth T (2011) Vitamin D and intestinal calcium absorption. Mol Cell Endocrinol 347:25–29PubMedPubMedCentral
42.
go back to reference Bronner F, Pansu D (1999) Nutritional aspects of calcium absorption. J Nutr 129:9–12PubMed Bronner F, Pansu D (1999) Nutritional aspects of calcium absorption. J Nutr 129:9–12PubMed
43.
go back to reference Mahan DC, Vallet JL (1997) Vitamin and mineral transfer during fetal development and the early postnatal period in pigs. J Anim Sci 75:2731–2738PubMed Mahan DC, Vallet JL (1997) Vitamin and mineral transfer during fetal development and the early postnatal period in pigs. J Anim Sci 75:2731–2738PubMed
44.
go back to reference Alexander RT, Rievaj J, Dimke H (2014) Paracellular calcium transport across renal and intestinal epithelia. Biochem Cell Biol 92:467–480PubMed Alexander RT, Rievaj J, Dimke H (2014) Paracellular calcium transport across renal and intestinal epithelia. Biochem Cell Biol 92:467–480PubMed
45.
go back to reference Pointillart A, Coxam V, Sève B, Colin C, Lacroix CH, Guéguen L (2000) Availability of calcium from skim milk, calcium sulfate and calcium carbonate for bone mineralization in pigs. Reprod Nutr Dev 40:49–61PubMed Pointillart A, Coxam V, Sève B, Colin C, Lacroix CH, Guéguen L (2000) Availability of calcium from skim milk, calcium sulfate and calcium carbonate for bone mineralization in pigs. Reprod Nutr Dev 40:49–61PubMed
Metadata
Title
Maternal 25-hydroxycholecalciferol during lactation improves intestinal calcium absorption and bone properties in sow-suckling piglet pairs
Authors
Lianhua Zhang
Jiangxu Hu
Miao Li
Qinghui Shang
Sujie Liu
Xiangshu Piao
Publication date
01-11-2019
Publisher
Springer Japan
Keyword
Lactation
Published in
Journal of Bone and Mineral Metabolism / Issue 6/2019
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-019-01020-0

Other articles of this Issue 6/2019

Journal of Bone and Mineral Metabolism 6/2019 Go to the issue
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.