Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 10/2017

01-10-2017 | Original Article – Cancer Research

MicroRNA-30a-5p (miR-30a) regulates cell motility and EMT by directly targeting oncogenic TM4SF1 in colorectal cancer

Authors: Y. R. Park, S. L. Kim, M. R. Lee, S. Y. Seo, J. H. Lee, S. H. Kim, I. H. Kim, S. O. Lee, S. T. Lee, Sang Wook Kim

Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2017

Login to get access

Abstract

Purpose

Colorectal cancer (CRC) is one of the leading causes of cancer death worldwide, and many oncogenes and tumor suppressor genes are involved in CRC. MicroRNAs (miRNAs) are small non-coding RNAs that can negatively regulate gene expression. Previous studies have revealed that miRNAs regulate the development and progression of many cancers. In this study, we investigated the role of microRNA-30a-5p (miR-30a) in CRC and its unknown mechanisms.

Methods

qRT-PCR was used to detect miR-30a and TM4SF1 mRNA expression in CRC specimens and cell lines. CRC cell migration and invasion were assessed after transfection with miR-30a or TM4SF1 using wound healing and trans-well migration and invasion assays. Transmembrane-4-L-six-family protein (TM4SF1) was validated as a target of miR-30a in CRC through luciferase reporter assay and bioinformatics algorithms. Moreover, two EMT regulators, E-cadherin and VEGF, were also identified using Western blotting and immunohistochemistry.

Results

We found that miR-30a was down-regulated in CRC tumor tissues and cell lines, and miR-30a was inversely associated with advanced stage and lymph node metastatic status compared with normal tissues. miR-30a decreased migration and invasion in CRC cell lines, and miR-30a overexpression not only down-regulated TM4SF1 mRNA and protein expression, but also inhibited the expression of VEGF and enhanced expression of E-cadherin. We also showed that TM4SF1 was up-regulated in CRC tumor specimens compared with adjacent normal tissues, and TM4SF1 expression was significantly associated with advanced stage and lymph node status compared with adjacent normal tissues.

Conclusions

These results suggest that miR-30a is an important regulator of TM4SF1, VEGF, and E-cadherin for CRC lymph node metastasis, a potential new therapeutic target in CRC.
Appendix
Available only for authorised users
Literature
go back to reference Allioli N, Vincent S, Vlaeminck-Guillem V, Decaussin-Petrucci M, Ragage F, Ruffion A, Samarut J (2011) TM4SF1, a novel primary androgen receptor target gene over-expressed in human prostate cancer and involved in cell migration. Prostate 71(11):1239–1250CrossRefPubMed Allioli N, Vincent S, Vlaeminck-Guillem V, Decaussin-Petrucci M, Ragage F, Ruffion A, Samarut J (2011) TM4SF1, a novel primary androgen receptor target gene over-expressed in human prostate cancer and involved in cell migration. Prostate 71(11):1239–1250CrossRefPubMed
go back to reference Baraniskin A, Birkenkamp-Demtroder K, Maghnouj A, Zollner H, Munding J, Klein-Scory S, Reinacher-Schick A, Schwarte-Waldhoff I, Schmiegel W, Hahn SA (2012) MiR-30a-5p suppresses tumor growth in colon carcinoma by targeting DTL. Carcinogenesis 33(4):732–739CrossRefPubMed Baraniskin A, Birkenkamp-Demtroder K, Maghnouj A, Zollner H, Munding J, Klein-Scory S, Reinacher-Schick A, Schwarte-Waldhoff I, Schmiegel W, Hahn SA (2012) MiR-30a-5p suppresses tumor growth in colon carcinoma by targeting DTL. Carcinogenesis 33(4):732–739CrossRefPubMed
go back to reference Calin GA, Liu CG, Sevignani C, Ferracin M, Felli N, Dumitru CD, Shimizu M, Cimmino A, Zupo S, Dono M et al (2004) MicroRNA profiling reveals distinct signatures in B cell chronic lymphocytic leukemias. Proc Natl Acad Sci U S A 101(32):11755–11760CrossRefPubMedPubMedCentral Calin GA, Liu CG, Sevignani C, Ferracin M, Felli N, Dumitru CD, Shimizu M, Cimmino A, Zupo S, Dono M et al (2004) MicroRNA profiling reveals distinct signatures in B cell chronic lymphocytic leukemias. Proc Natl Acad Sci U S A 101(32):11755–11760CrossRefPubMedPubMedCentral
go back to reference Cao H, Xu E, Liu H, Wan L, Lai M (2015) Epithelial-mesenchymal transition in colorectal cancer metastasis: a system review. Pathol Res Pract 211(8):557–569CrossRefPubMed Cao H, Xu E, Liu H, Wan L, Lai M (2015) Epithelial-mesenchymal transition in colorectal cancer metastasis: a system review. Pathol Res Pract 211(8):557–569CrossRefPubMed
go back to reference Chang YW, Chen SC, Cheng EC, Ko YP, Lin YC, Kao YR, Tsay YG, Yang PC, Wu CW, Roffler SR (2005) CD13 (aminopeptidase N) can associate with tumor-associated antigen L6 and enhance the motility of human lung cancer cells. Int J Cancer 116(2):243–252CrossRefPubMed Chang YW, Chen SC, Cheng EC, Ko YP, Lin YC, Kao YR, Tsay YG, Yang PC, Wu CW, Roffler SR (2005) CD13 (aminopeptidase N) can associate with tumor-associated antigen L6 and enhance the motility of human lung cancer cells. Int J Cancer 116(2):243–252CrossRefPubMed
go back to reference Cheng CW, Wang HW, Chang CW, Chu HW, Chen CY, Yu JC, Chao JI, Liu HF, Ding SL, Shen CY (2012) MicroRNA-30a inhibits cell migration and invasion by downregulating vimentin expression and is a potential prognostic marker in breast cancer. Breast Cancer Res Treat 134(3):1081–1093CrossRefPubMed Cheng CW, Wang HW, Chang CW, Chu HW, Chen CY, Yu JC, Chao JI, Liu HF, Ding SL, Shen CY (2012) MicroRNA-30a inhibits cell migration and invasion by downregulating vimentin expression and is a potential prognostic marker in breast cancer. Breast Cancer Res Treat 134(3):1081–1093CrossRefPubMed
go back to reference Chu E (2010) Colorectal cancer (CRC) continues to be a major public health problem in the United States and throughout the world. Cancer J 16(3):195CrossRefPubMed Chu E (2010) Colorectal cancer (CRC) continues to be a major public health problem in the United States and throughout the world. Cancer J 16(3):195CrossRefPubMed
go back to reference Fu J, Xu X, Kang L, Zhou L, Wang S, Lu J, Cheng L, Fan Z, Yuan B, Tian P et al (2014) miR-30a suppresses breast cancer cell proliferation and migration by targeting Eya2. Biochem Biophys Res Commun 445(2):314–319CrossRefPubMed Fu J, Xu X, Kang L, Zhou L, Wang S, Lu J, Cheng L, Fan Z, Yuan B, Tian P et al (2014) miR-30a suppresses breast cancer cell proliferation and migration by targeting Eya2. Biochem Biophys Res Commun 445(2):314–319CrossRefPubMed
go back to reference Hellstrom I, Horn D, Linsley P, Brown JP, Brankovan V, Hellstrom KE (1986) Monoclonal mouse antibodies raised against human lung carcinoma. Cancer Res 46(8):3917–3923PubMed Hellstrom I, Horn D, Linsley P, Brown JP, Brankovan V, Hellstrom KE (1986) Monoclonal mouse antibodies raised against human lung carcinoma. Cancer Res 46(8):3917–3923PubMed
go back to reference Huang MY, Wang HM, Chang HJ, Hsiao CP, Wang JY, Lin SR (2012) Overexpression of S100B, TM4SF4, and OLFM4 genes is correlated with liver metastasis in Taiwanese colorectal cancer patients. DNA Cell Biol 31(1):43–49CrossRefPubMedPubMedCentral Huang MY, Wang HM, Chang HJ, Hsiao CP, Wang JY, Lin SR (2012) Overexpression of S100B, TM4SF4, and OLFM4 genes is correlated with liver metastasis in Taiwanese colorectal cancer patients. DNA Cell Biol 31(1):43–49CrossRefPubMedPubMedCentral
go back to reference Huang YK, Fan XG, Qiu F (2016) TM4SF1 promotes proliferation, invasion, and metastasis in human liver cancer cells. Int J Mol Sci 17(5):E661CrossRefPubMed Huang YK, Fan XG, Qiu F (2016) TM4SF1 promotes proliferation, invasion, and metastasis in human liver cancer cells. Int J Mol Sci 17(5):E661CrossRefPubMed
go back to reference Kang Y, Massague J (2004) Epithelial-mesenchymal transitions: twist in development and metastasis. Cell 118(3):277–279CrossRefPubMed Kang Y, Massague J (2004) Epithelial-mesenchymal transitions: twist in development and metastasis. Cell 118(3):277–279CrossRefPubMed
go back to reference Kao YR, Shih JY, Wen WC, Ko YP, Chen BM, Chan YL, Chu YW, Yang PC, Wu CW, Roffler SR (2003) Tumor-associated antigen L6 and the invasion of human lung cancer cells. Clin Cancer Res 9(7):2807–2816PubMed Kao YR, Shih JY, Wen WC, Ko YP, Chen BM, Chan YL, Chu YW, Yang PC, Wu CW, Roffler SR (2003) Tumor-associated antigen L6 and the invasion of human lung cancer cells. Clin Cancer Res 9(7):2807–2816PubMed
go back to reference Kumarswamy R, Mudduluru G, Ceppi P, Muppala S, Kozlowski M, Niklinski J, Papotti M, Allgayer H (2012) MicroRNA-30a inhibits epithelial-to-mesenchymal transition by targeting Snai1 and is downregulated in non-small cell lung cancer. Int J Cancer 130(9):2044–2053CrossRefPubMed Kumarswamy R, Mudduluru G, Ceppi P, Muppala S, Kozlowski M, Niklinski J, Papotti M, Allgayer H (2012) MicroRNA-30a inhibits epithelial-to-mesenchymal transition by targeting Snai1 and is downregulated in non-small cell lung cancer. Int J Cancer 130(9):2044–2053CrossRefPubMed
go back to reference Lekishvili T, Fromm E, Mujoomdar M, Berditchevski F (2008) The tumour-associated antigen L6 (L6-Ag) is recruited to the tetraspanin-enriched microdomains: implication for tumour cell motility. J Cell Sci 121(5):685–694CrossRefPubMedPubMedCentral Lekishvili T, Fromm E, Mujoomdar M, Berditchevski F (2008) The tumour-associated antigen L6 (L6-Ag) is recruited to the tetraspanin-enriched microdomains: implication for tumour cell motility. J Cell Sci 121(5):685–694CrossRefPubMedPubMedCentral
go back to reference Li X, Zhang Y, Zhang Y, Ding J, Wu K, Fan D (2010) Survival prediction of gastric cancer by a seven-microRNA signature. Gut 59(5):579–585CrossRefPubMed Li X, Zhang Y, Zhang Y, Ding J, Wu K, Fan D (2010) Survival prediction of gastric cancer by a seven-microRNA signature. Gut 59(5):579–585CrossRefPubMed
go back to reference Li WF, Dai H, Ou Q, Zuo GQ, Liu CA (2015) Overexpression of microRNA-30a-5p inhibits liver cancer cell proliferation and induces apoptosis by targeting MTDH/PTEN/AKT pathway. Tumour Biol 37(5):5885–5895CrossRefPubMed Li WF, Dai H, Ou Q, Zuo GQ, Liu CA (2015) Overexpression of microRNA-30a-5p inhibits liver cancer cell proliferation and induces apoptosis by targeting MTDH/PTEN/AKT pathway. Tumour Biol 37(5):5885–5895CrossRefPubMed
go back to reference Lin CI, Merley A, Sciuto TE, Li D, Dvorak AM, Melero-Martin JM, Dvorak HF, Jaminet SC (2014) TM4SF1: a new vascular therapeutic target in cancer. Angiogenesis 17(4):897–907CrossRefPubMedPubMedCentral Lin CI, Merley A, Sciuto TE, Li D, Dvorak AM, Melero-Martin JM, Dvorak HF, Jaminet SC (2014) TM4SF1: a new vascular therapeutic target in cancer. Angiogenesis 17(4):897–907CrossRefPubMedPubMedCentral
go back to reference Ma H, Pan JS, Jin LX, Wu J, Ren YD, Chen P, Xiao C, Han J (2016) MicroRNA-17 ~ 92 inhibits colorectal cancer progression by targeting angiogenesis. Cancer Lett 376(2):293–302CrossRefPubMed Ma H, Pan JS, Jin LX, Wu J, Ren YD, Chen P, Xiao C, Han J (2016) MicroRNA-17 ~ 92 inhibits colorectal cancer progression by targeting angiogenesis. Cancer Lett 376(2):293–302CrossRefPubMed
go back to reference Macfarlane LA, Murphy PR (2010) MicroRNA: biogenesis, function and role in cancer. Curr Genom 11(7):537–561CrossRef Macfarlane LA, Murphy PR (2010) MicroRNA: biogenesis, function and role in cancer. Curr Genom 11(7):537–561CrossRef
go back to reference Nieto MA (2011) The ins and outs of the epithelial to mesenchymal transition in health and disease. Annu Rev Cell Dev Biol 27:347–376CrossRefPubMed Nieto MA (2011) The ins and outs of the epithelial to mesenchymal transition in health and disease. Annu Rev Cell Dev Biol 27:347–376CrossRefPubMed
go back to reference Park YR, Lee ST, Kim SL, Liu YC, Lee MR, Shin JH, Seo SY, Kim SH, Kim IH, Lee SO, Kim SW (2016) MicroRNA-9 suppresses cell migration and invasion through downregulation of TM4SF1 in colorectal cancer. Int J Oncol 48(5):2135–2143CrossRefPubMed Park YR, Lee ST, Kim SL, Liu YC, Lee MR, Shin JH, Seo SY, Kim SH, Kim IH, Lee SO, Kim SW (2016) MicroRNA-9 suppresses cell migration and invasion through downregulation of TM4SF1 in colorectal cancer. Int J Oncol 48(5):2135–2143CrossRefPubMed
go back to reference Seo DC, Sung JM, Cho HJ, Yi H, Seo KH, Choi IS, Kim DK, Kim JS, El-Aty AA, Shin HC (2007) Gene expression profiling of cancer stem cell in human lung adenocarcinoma A549 cells. Mol Cancer 6:75CrossRefPubMedPubMedCentral Seo DC, Sung JM, Cho HJ, Yi H, Seo KH, Choi IS, Kim DK, Kim JS, El-Aty AA, Shin HC (2007) Gene expression profiling of cancer stem cell in human lung adenocarcinoma A549 cells. Mol Cancer 6:75CrossRefPubMedPubMedCentral
go back to reference Shih SC, Zukauskas A, Li D, Liu G, Ang LH, Nagy JA, Brown LF, Dvorak HF (2009) The L6 protein TM4SF1 is critical for endothelial cell function and tumor angiogenesis. Cancer Res 69(8):3272–3277CrossRefPubMedPubMedCentral Shih SC, Zukauskas A, Li D, Liu G, Ang LH, Nagy JA, Brown LF, Dvorak HF (2009) The L6 protein TM4SF1 is critical for endothelial cell function and tumor angiogenesis. Cancer Res 69(8):3272–3277CrossRefPubMedPubMedCentral
go back to reference Spaderna S, Schmalhofer O, Hlubek F, Berx G, Eger A, Merkel S, Jung A, Kirchner T, Brabletz T (2006) A transient, EMT-linked loss of basement membranes indicates metastasis and poor survival in colorectal cancer. Gastroenterology 131(3):830–840CrossRefPubMed Spaderna S, Schmalhofer O, Hlubek F, Berx G, Eger A, Merkel S, Jung A, Kirchner T, Brabletz T (2006) A transient, EMT-linked loss of basement membranes indicates metastasis and poor survival in colorectal cancer. Gastroenterology 131(3):830–840CrossRefPubMed
go back to reference Tutar Y (2014) miRNA and cancer; computational and experimental approaches. Curr Pharm Biotechnol 15(5):429CrossRefPubMed Tutar Y (2014) miRNA and cancer; computational and experimental approaches. Curr Pharm Biotechnol 15(5):429CrossRefPubMed
go back to reference Valencia-Sanchez MA, Liu J, Hannon GJ, Parker R (2006) Control of translation and mRNA degradation by miRNAs and siRNAs. Genes Dev 20(5):515–524CrossRefPubMed Valencia-Sanchez MA, Liu J, Hannon GJ, Parker R (2006) Control of translation and mRNA degradation by miRNAs and siRNAs. Genes Dev 20(5):515–524CrossRefPubMed
go back to reference Visintin A, Knowlton K, Tyminski E, Lin CI, Zheng X, Marquette K, Jain S, Tchistiakova L, Li D, O’Donnell CJ et al (2015) Novel Anti-TM4SF1 antibody–drug conjugates with activity against tumor cells and tumor vasculature. Mol Cancer Ther 14(8):1868–1876CrossRefPubMed Visintin A, Knowlton K, Tyminski E, Lin CI, Zheng X, Marquette K, Jain S, Tchistiakova L, Li D, O’Donnell CJ et al (2015) Novel Anti-TM4SF1 antibody–drug conjugates with activity against tumor cells and tumor vasculature. Mol Cancer Ther 14(8):1868–1876CrossRefPubMed
go back to reference Visone R, Pallante P, Vecchione A, Cirombella R, Ferracin M, Ferraro A, Volinia S, Coluzzi S, Leone V, Borbone E et al (2007) Specific microRNAs are downregulated in human thyroid anaplastic carcinomas. Oncogene 26(54):7590–7595CrossRefPubMed Visone R, Pallante P, Vecchione A, Cirombella R, Ferracin M, Ferraro A, Volinia S, Coluzzi S, Leone V, Borbone E et al (2007) Specific microRNAs are downregulated in human thyroid anaplastic carcinomas. Oncogene 26(54):7590–7595CrossRefPubMed
go back to reference Wang X, Chen L, Jin H, Wang S, Zhang Y, Tang X, Tang G (2016) Screening miRNAs for early diagnosis of colorectal cancer by small RNA deep sequencing and evaluation in a Chinese patient population. OncoTargets Ther 9:1159–1166 Wang X, Chen L, Jin H, Wang S, Zhang Y, Tang X, Tang G (2016) Screening miRNAs for early diagnosis of colorectal cancer by small RNA deep sequencing and evaluation in a Chinese patient population. OncoTargets Ther 9:1159–1166
go back to reference Wei W, Yang Y, Cai J, Cui K, Li RX, Wang H, Shang X, Wei D (2016) MiR-30a-5p suppresses tumor metastasis of human colorectal cancer by targeting ITGB3. Cell Physiol Biochem 39(3):1165–1176CrossRefPubMed Wei W, Yang Y, Cai J, Cui K, Li RX, Wang H, Shang X, Wei D (2016) MiR-30a-5p suppresses tumor metastasis of human colorectal cancer by targeting ITGB3. Cell Physiol Biochem 39(3):1165–1176CrossRefPubMed
go back to reference William KKW, Joseph JYS (2012) MicroRNA dysregulations in gastrointestinal cancers: pathophysiological and clinical perspectives. Intest Res 10(4):324–331CrossRef William KKW, Joseph JYS (2012) MicroRNA dysregulations in gastrointestinal cancers: pathophysiological and clinical perspectives. Intest Res 10(4):324–331CrossRef
go back to reference Yan Q, Zhang W, Wu Y, Wu M, Zhang M, Shi X, Zhao J, Nan Q, Chen Y, Wang L et al (2015) KLF8 promotes tumorigenesis, invasion and metastasis of colorectal cancer cells by transcriptional activation of FHL2. Oncotarget 6(28):25402–25417CrossRefPubMedPubMedCentral Yan Q, Zhang W, Wu Y, Wu M, Zhang M, Shi X, Zhao J, Nan Q, Chen Y, Wang L et al (2015) KLF8 promotes tumorigenesis, invasion and metastasis of colorectal cancer cells by transcriptional activation of FHL2. Oncotarget 6(28):25402–25417CrossRefPubMedPubMedCentral
go back to reference Yuan Y, Zheng S, Li Q, Xiang X, Gao T, Ran P, Sun L, Huang Q, Xie F, Du J, Xiao C (2016) Overexpression of miR-30a in lung adenocarcinoma A549 cell line inhibits migration and invasion via targeting EYA2. Acta Biochim Biophy Sin 48(3):220–228CrossRef Yuan Y, Zheng S, Li Q, Xiang X, Gao T, Ran P, Sun L, Huang Q, Xie F, Du J, Xiao C (2016) Overexpression of miR-30a in lung adenocarcinoma A549 cell line inhibits migration and invasion via targeting EYA2. Acta Biochim Biophy Sin 48(3):220–228CrossRef
go back to reference Zhang N, Wang X, Huo Q, Sun M, Cai C, Liu Z, Hu G, Yang Q (2014) MicroRNA-30a suppresses breast tumor growth and metastasis by targeting metadherin. Oncogene 33(24):3119–3128CrossRefPubMed Zhang N, Wang X, Huo Q, Sun M, Cai C, Liu Z, Hu G, Yang Q (2014) MicroRNA-30a suppresses breast tumor growth and metastasis by targeting metadherin. Oncogene 33(24):3119–3128CrossRefPubMed
go back to reference Zhang Q, Tang Q, Qin D, Yu L, Huang R, Lv G, Zou Z, Jiang XC, Zou C, Liu W et al (2015) Role of microRNA 30a targeting insulin receptor substrate 2 in colorectal tumorigenesis. Mol Cell Biol 35(6):988–1000CrossRefPubMedPubMedCentral Zhang Q, Tang Q, Qin D, Yu L, Huang R, Lv G, Zou Z, Jiang XC, Zou C, Liu W et al (2015) Role of microRNA 30a targeting insulin receptor substrate 2 in colorectal tumorigenesis. Mol Cell Biol 35(6):988–1000CrossRefPubMedPubMedCentral
go back to reference Zhong M, Bian Z, Wu Z (2013) miR-30a suppresses cell migration and invasion through downregulation of PIK3CD in colorectal carcinoma. Cell Physiol Biochem 31(2–3):209–218CrossRefPubMed Zhong M, Bian Z, Wu Z (2013) miR-30a suppresses cell migration and invasion through downregulation of PIK3CD in colorectal carcinoma. Cell Physiol Biochem 31(2–3):209–218CrossRefPubMed
Metadata
Title
MicroRNA-30a-5p (miR-30a) regulates cell motility and EMT by directly targeting oncogenic TM4SF1 in colorectal cancer
Authors
Y. R. Park
S. L. Kim
M. R. Lee
S. Y. Seo
J. H. Lee
S. H. Kim
I. H. Kim
S. O. Lee
S. T. Lee
Sang Wook Kim
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 10/2017
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-017-2440-4

Other articles of this Issue 10/2017

Journal of Cancer Research and Clinical Oncology 10/2017 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.