Top

22-04-2024 | Semaglutide | Original Article

Semaglutide attenuates pathological electrophysiological remodeling in diabetic cardiomyopathy via restoring Cx43 expression

Authors: Meiling Yan, Kaibin Lin, Dong Huang, Jingbo Li, Xinkai Qu, Kankai Chen

Published in: Endocrine

Abstract

Background

Semaglutide is a relatively new anti-hyperglycemic agent that was shown to carry cardioprotective potentials. However, the exact effects of semaglutide on diabetic cardiomyopathy (DCM) and their underlining mechanism remain unclear. This study aimed to evaluate the effects of semaglutide on myocardium injury and cardiac function in DCM mice and its potential mechanisms, with emphasis on its effects on Cx43 and electrophysiological remodeling.

Methods

C57BL/6 mice were randomly divided into four groups: control group, semaglutide group, diabetes group, and diabetes + semaglutide treatment group. Type 1 diabetes were induced by intraperitoneal injection of streptozotocin. Mice in the semaglutide intervention group were injected subcutaneously with semaglutide (0.15 mg/kg) every week for 8 weeks. The blood glucose, cardiac function, oxidative stress markers, apoptosis, expression of Sirt1, AMPK, Cx43, and electrocardiogram of mice in each group were evaluated.

Results

Treatment with semaglutide alleviated glucose metabolism disorders and improved cardiac dysfunction in diabetic mice. In addition, semaglutide ameliorated the increase in oxidative stress and apoptosis in diabetic heart. Sirt1/AMPK pathway was activated after semaglutide treatment. Furthermore, diabetic mice showed reduced expression of Cx43 in the myocardium, accompanied by changes in electrocardiogram, including significantly prolonged RR, QRS, QT and QTc interval. Semaglutide treatment restored Cx43 expression and reversed the above-mentioned ECG abnormalities.

Conclusions

Our research results showed that semaglutide protected against oxidative stress and apoptosis in diabetic heart, thereby improving cardiac function and electrophysiological remodelling in DCM mice, which may attribute to activation of Sirt1/AMPK pathway and restore of Cx43 expression.

P. Saeedi, I. Petersohn, P. Salpea, B. Malanda, S. Karuranga, N. Unwin, S. Colagiuri, L. Guariguata, A.A. Motala, K. Ogurtsova, J.E. Shaw, D. Bright, R. Williams, Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res. Clin. Pract. 157, 107843 (2019). https://doi.org/10.1016/j.diabres.2019.107843CrossRefPubMed

W.B. Kannel, M. Hjortland, W.P. Castelli, Role of diabetes in congestive heart failure: the Framingham study. Am. J. Cardiol. 34(1), 29–34 (1974). https://doi.org/10.1016/0002-9149(74)90089-7CrossRefPubMed

W.H. Dillmann, Diabetic cardiomyopathy. Circ. Res 124(8), 1160–1162 (2019). https://doi.org/10.1161/circresaha.118.314665CrossRefPubMedPubMedCentral

R.H. Ritchie, E.D. Abel, Basic mechanisms of diabetic heart disease. Circ. Res. 126(11), 1501–1525 (2020). https://doi.org/10.1161/circresaha.120.315913CrossRefPubMedPubMedCentral

G. Borghetti, D. von Lewinski, D.M. Eaton, H. Sourij, S.R. Houser, M. Wallner, Diabetic cardiomyopathy: current and future therapies. beyond glycemic control. Front. Physiol. 9, 1514 (2018). https://doi.org/10.3389/fphys.2018.01514CrossRefPubMedPubMedCentral

Y. Tan, Z. Zhang, C. Zheng, K.A. Wintergerst, B.B. Keller, L. Cai, Mechanisms of diabetic cardiomyopathy and potential therapeutic strategies: preclinical and clinical evidence. Nat. Rev. Cardiol. 17(9), 585–607 (2020). https://doi.org/10.1038/s41569-020-0339-2CrossRefPubMedPubMedCentral

S. Paolillo, F. Marsico, M. Prastaro, F. Renga, L. Esposito, F. De Martino, P. Di Napoli, I. Esposito, A. Ambrosio, M. Ianniruberto, R. Mennella, R. Paolillo, P. Gargiulo, Diabetic cardiomyopathy: definition, diagnosis, and therapeutic implications. Heart Fail. Clin. 15(3), 341–347 (2019). https://doi.org/10.1016/j.hfc.2019.02.003CrossRefPubMed

Q. Liu, S. Wang, L. Cai, Diabetic cardiomyopathy and its mechanisms: role of oxidative stress and damage. J. Diabetes Investig. 5(6), 623–634 (2014). https://doi.org/10.1111/jdi.12250CrossRefPubMedPubMedCentral

V.U. Nna, A.B. Abu Bakar, A. Ahmad, C.O. Eleazu, M. Mohamed, Oxidative stress, NF-κB-mediated inflammation and apoptosis in the testes of streptozotocin-induced diabetic rats: combined protective effects of Malaysian propolis and metformin. Antioxidants 8(10), (2019). https://doi.org/10.3390/antiox8100465

10.

S. Boudina, E.D. Abel, Diabetic cardiomyopathy, causes and effects. Rev. Endocr. Metab. Disord. 11(1), 31–39 (2010). https://doi.org/10.1007/s11154-010-9131-7CrossRefPubMedPubMedCentral

11.

M.J. Cutler, D. Jeyaraj, D.S. Rosenbaum, Cardiac electrical remodeling in health and disease. Trends Pharmacol. Sci. 32(3), 174–180 (2011). https://doi.org/10.1016/j.tips.2010.12.001CrossRefPubMedPubMedCentral

12.

F.M. Gribble, F. Reimann, Metabolic messengers: glucagon-like peptide 1. Nat. Metab. 3(2), 142–148 (2021). https://doi.org/10.1038/s42255-020-00327-xCrossRefPubMed

13.

S. Pandey, S. Mangmool, W. Parichatikanond, Multifaceted roles of GLP-1 and its analogs: a review on molecular mechanisms with a cardiotherapeutic perspective. Pharmaceuticals 16(6), (2023). https://doi.org/10.3390/ph16060836

14.

K. Gopal, J.J. Chahade, R. Kim, J.R. Ussher, The impact of antidiabetic therapies on diastolic dysfunction and diabetic cardiomyopathy. Front. Physiol. 11, 603247 (2020). https://doi.org/10.3389/fphys.2020.603247CrossRefPubMedPubMedCentral

15.

M.P. Gilbert, R.E. Pratley, GLP-1 analogs and DPP-4 inhibitors in type 2 diabetes therapy: review of head-to-head clinical trials. Front. Endocrinol. 11, 178 (2020). https://doi.org/10.3389/fendo.2020.00178CrossRef

16.

H. Yaribeygi, A. Rashidy-Pour, S.L. Atkin, T. Jamialahmadi, A. Sahebkar, GLP-1 mimetics and cognition. Life Sci. 264, 118645 (2021). https://doi.org/10.1016/j.lfs.2020.118645CrossRefPubMed

17.

X. Ma, Z. Liu, I. Ilyas, P.J. Little, D. Kamato, A. Sahebka, Z. Chen, S. Luo, X. Zheng, J. Weng, S. Xu, GLP-1 receptor agonists (GLP-1RAs): cardiovascular actions and therapeutic potential. Int. J. Biol. Sci. 17(8), 2050–2068 (2021). https://doi.org/10.7150/ijbs.59965CrossRefPubMedPubMedCentral

18.

E. Andrikou, C. Tsioufis, I. Andrikou, I. Leontsinis, D. Tousoulis, N. Papanas, GLP-1 receptor agonists and cardiovascular outcome trials: An update. Hell. J. Cardiol. (Hellenike Kardiologike Epitheorese) 60(6), 347–351 (2019). https://doi.org/10.1016/j.hjc.2018.11.008CrossRef

19.

J.R. Ussher, D.J. Drucker, Glucagon-like peptide 1 receptor agonists: cardiovascular benefits and mechanisms of action. Nat. Rev. Cardiol. 20(7), 463–474 (2023). https://doi.org/10.1038/s41569-023-00849-3CrossRefPubMed

20.

Y. Li, P.D. Rosenblit, Glucagon-like peptide-1 receptor agonists and cardiovascular risk reduction in type 2 diabetes mellitus: is it a class effect? Curr. Cardiol. Rep. 20(11), 113 (2018). https://doi.org/10.1007/s11886-018-1051-2CrossRefPubMed

21.

S. Mangmool, P. Hemplueksa, W. Parichatikanond, N. Chattipakorn, Epac is required for GLP-1R-mediated inhibition of oxidative stress and apoptosis in cardiomyocytes. Mol. Endocrinol. 29(4), 583–596 (2015). https://doi.org/10.1210/me.2014-1346CrossRefPubMedPubMedCentral

22.

N.M. Ramadan, H.A. Malek, K.A. Rahman, E. El-Kholy, D. Shaalan, W. Elkashef, Liraglutide effect on ventricular transient outward K+ channel and connexin-43 protein expression. Exp. Clin. Endocrinol. Diabetes 129(12), 899–907 (2021). https://doi.org/10.1055/a-1162-8196CrossRefPubMed

23.

S.P. Marso, S.C. Bain, A. Consoli, F.G. Eliaschewitz, E. Jódar, L.A. Leiter, I. Lingvay, J. Rosenstock, J. Seufert, M.L. Warren, V. Woo, O. Hansen, A.G. Holst, J. Pettersson, T. Vilsbøll, Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N. Engl. J. Med. 375(19), 1834–1844 (2016). https://doi.org/10.1056/NEJMoa1607141CrossRefPubMed

24.

M. Husain, A.L. Birkenfeld, M. Donsmark, K. Dungan, F.G. Eliaschewitz, D.R. Franco, O.K. Jeppesen, I. Lingvay, O. Mosenzon, S.D. Pedersen, C.J. Tack, M. Thomsen, T. Vilsbøll, M.L. Warren, S.C. Bain, Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N. Engl. J. Med. 381(9), 841–851 (2019). https://doi.org/10.1056/NEJMoa1901118CrossRefPubMed

25.

K. Sakaguchi, K. Takeda, M. Maeda, W. Ogawa, T. Sato, S. Okada, Y. Ohnishi, H. Nakajima, A. Kashiwagi, Glucose area under the curve during oral glucose tolerance test as an index of glucose intolerance. Diabetol. Int. 7(1), 53–58 (2016). https://doi.org/10.1007/s13340-015-0212-4CrossRefPubMed

26.

G.F. Mitchell, A. Jeron, G. Koren, Measurement of heart rate and Q-T interval in the conscious mouse. Am. J. Physiol. 274(3), H747–H751 (1998). https://doi.org/10.1152/ajpheart.1998.274.3.H747CrossRefPubMed

27.

T. Zhao, H. Chen, F. Xu, J. Wang, Y. Liu, X. Xing, L. Guo, M. Zhang, Q. Lu, Liraglutide alleviates cardiac fibrosis through inhibiting P4hα-1 expression in STZ-induced diabetic cardiomyopathy. Acta Biochim. Biophys. Sin. 51(3), 293–300 (2019). https://doi.org/10.1093/abbs/gmy177CrossRefPubMed

28.

E. Robinson, R.S. Cassidy, M. Tate, Y. Zhao, S. Lockhart, D. Calderwood, R. Church, M.K. McGahon, D.P. Brazil, B.J. McDermott, B.D. Green, D.J. Grieve, Exendin-4 protects against post-myocardial infarction remodelling via specific actions on inflammation and the extracellular matrix. Basic Res. Cardiol. 110(2), 20 (2015). https://doi.org/10.1007/s00395-015-0476-7CrossRefPubMedPubMedCentral

29.

G. Bendotti, L. Montefusco, M.E. Lunati, V. Usuelli, I. Pastore, E. Lazzaroni, E. Assi, A.J. Seelam, B. El Essawy, J. Jang, C. Loretelli, F. D’Addio, C. Berra, M. Ben Nasr, G. Zuccotti, P. Fiorina, The anti-inflammatory and immunological properties of GLP-1 receptor agonists. Pharm. Res. 182, 106320 (2022). https://doi.org/10.1016/j.phrs.2022.106320CrossRef

30.

A. Sforza, V. Vigorelli, E. Rurali, G.L. Perrucci, E. Gambini, M. Arici, A. Metallo, R. Rinaldi, P. Fiorina, A. Barbuti, A. Raucci, E. Sacco, M. Rocchetti, G. Pompilio, S. Genovese, M.C. Vinci, Liraglutide preserves CD34+ stem cells from dysfunction Induced by high glucose exposure. Cardiovasc. Diabetol. 21(1), 51 (2022). https://doi.org/10.1186/s12933-022-01486-9CrossRefPubMedPubMedCentral

31.

G.G. Sokos, L.A. Nikolaidis, S. Mankad, D. Elahi, R.P. Shannon, Glucagon-like peptide-1 infusion improves left ventricular ejection fraction and functional status in patients with chronic heart failure. J. Card. Fail. 12(9), 694–699 (2006). https://doi.org/10.1016/j.cardfail.2006.08.211CrossRefPubMed

32.

B. De Geest, M. Mishra, Role of oxidative stress in diabetic cardiomyopathy. Antioxidants 11(4), (2022). https://doi.org/10.3390/antiox11040784

33.

W. Ding, W.G. Chang, X.C. Guo, Y. Liu, D.D. Xiao, D. Ding, J.X. Wang, X.J. Zhang, Exenatide protects against cardiac dysfunction by attenuating oxidative stress in the diabetic mouse heart. Front. Endocrinol. 10, 202 (2019). https://doi.org/10.3389/fendo.2019.00202CrossRef

34.

A. Winiarska, M. Knysak, K. Nabrdalik, J. Gumprecht, T. Stompór, Inflammation and oxidative stress in diabetic kidney disease: the targets for SGLT2 inhibitors and GLP-1 receptor agonists. Int. J. Mol. Sci. 22(19), (2021). https://doi.org/10.3390/ijms221910822

35.

P. Fiorina, G. Lattuada, O. Ponari, C. Silvestrini, P. DallAglio, Impaired nocturnal melatonin excretion and changes of immunological status in ischaemic stroke patients. Lancet 347(9002), 692–693 (1996)CrossRefPubMed

36.

A. Monji, T. Mitsui, Y.K. Bando, M. Aoyama, T. Shigeta, T. Murohara, Glucagon-like peptide-1 receptor activation reverses cardiac remodeling via normalizing cardiac steatosis and oxidative stress in type 2 diabetes. Am. J. Physiol. Heart Circ. Physiol. 305(3), H295–H304 (2013). https://doi.org/10.1152/ajpheart.00990.2012CrossRefPubMed

37.

Y. Liu, L. Chen, H. Wu, H. Zhang, Protective effect of glucagon-like peptide-1 mediated by ultrasound microbubbles on myocardial injury in rats with diabetic cardiomyopathy. Bioengineered 13(2), 3251–3261 (2022). https://doi.org/10.1080/21655979.2021.2022270CrossRefPubMedPubMedCentral

38.

S.S. Hansen, E. Aasum, A.D. Hafstad, The role of NADPH oxidases in diabetic cardiomyopathy. Biochim. Biophys. Acta Mol. Basis Dis. 1864(5 Pt B), 1908–1913 (2018). https://doi.org/10.1016/j.bbadis.2017.07.025CrossRefPubMed

39.

C.M. Kusminski, S. Shetty, L. Orci, R.H. Unger, P.E. Scherer, Diabetes and apoptosis: lipotoxicity. Apoptosis 14(12), 1484–1495 (2009). https://doi.org/10.1007/s10495-009-0352-8CrossRefPubMed

40.

L. Wu, K. Wang, W. Wang, Z. Wen, P. Wang, L. Liu, D.W. Wang, Glucagon-like peptide-1 ameliorates cardiac lipotoxicity in diabetic cardiomyopathy via the PPARα pathway. Aging Cell 17(4), e12763 (2018). https://doi.org/10.1111/acel.12763CrossRefPubMedPubMedCentral

41.

S. Ravassa, A. Zudaire, R.D. Carr, J. Díez, Antiapoptotic effects of GLP-1 in murine HL-1 cardiomyocytes. Am. J. Physiol. Heart Circ. Physiol. 300(4), H1361–H1372 (2011). https://doi.org/10.1152/ajpheart.00885.2010CrossRefPubMed

42.

H. Zhang, Z. Xiong, J. Wang, S. Zhang, L. Lei, L. Yang, Z. Zhang, Glucagon-like peptide-1 protects cardiomyocytes from advanced oxidation protein product-induced apoptosis via the PI3K/Akt/Bad signaling pathway. Mol. Med. Rep. 13(2), 1593–1601 (2016). https://doi.org/10.3892/mmr.2015.4724CrossRefPubMed

43.

N.N. Trang, C.C. Chung, T.W. Lee, W.L. Cheng, Y.H. Kao, S.Y. Huang, T.I. Lee, Y.J. Chen, Empagliflozin and liraglutide differentially modulate cardiac metabolism in diabetic cardiomyopathy in rats. Int. J. Mol. Sci. 22(3), (2021). https://doi.org/10.3390/ijms22031177

44.

Q. Zhu, Y. Luo, Y. Wen, D. Wang, J. Li, Z. Fan, Semaglutide inhibits ischemia/reperfusion-induced cardiomyocyte apoptosis through activating PKG/PKCε/ERK1/2 pathway. Biochem. Biophys. Res. Commun. 647, 1–8 (2023). https://doi.org/10.1016/j.bbrc.2023.01.049CrossRefPubMed

45.

A.J. Wang, S. Wang, B.J. Wang, M. Xiao, Y. Guo, Y. Tang, J. Zhang, J. Gu, Epigenetic regulation associated with sirtuin 1 in complications of diabetes mellitus. Front. Endocrinol. 11, 598012 (2020). https://doi.org/10.3389/fendo.2020.598012CrossRef

46.

C. Lu, H. Zhao, Y. Liu, Z. Yang, H. Yao, T. Liu, T. Gou, L. Wang, J. Zhang, Y. Tian, Y. Yang, H. Zhang, Novel role of the SIRT1 in endocrine and metabolic diseases. Int. J. Biol. Sci. 19(2), 484–501 (2023). https://doi.org/10.7150/ijbs.78654CrossRefPubMedPubMedCentral

47.

S. Seksaria, S. Mehan, B.J. Dutta, G.D. Gupta, S.S. Ganti, A. Singh, Oxymatrine and insulin resistance: focusing on mechanistic intricacies involve in diabetes associated cardiomyopathy via SIRT1/AMPK and TGF-β signaling pathway. J. Biochem. Mol. Toxicol. 37(5), e23330 (2023). https://doi.org/10.1002/jbt.23330CrossRefPubMed

48.

W. Jia, T. Bai, J. Zeng, Z. Niu, D. Fan, X. Xu, M. Luo, P. Wang, Q. Zou, X. Dai, Combined administration of metformin and atorvastatin attenuates diabetic cardiomyopathy by inhibiting inflammation, apoptosis, and oxidative stress in type 2 diabetic mice. Front. Cell Dev. Biol. 9, 634900 (2021). https://doi.org/10.3389/fcell.2021.634900CrossRefPubMedPubMedCentral

49.

T. Inoue, T. Inoguchi, N. Sonoda, H. Hendarto, H. Makimura, S. Sasaki, H. Yokomizo, Y. Fujimura, D. Miura, R. Takayanagi, GLP-1 analog liraglutide protects against cardiac steatosis, oxidative stress and apoptosis in streptozotocin-induced diabetic rats. Atherosclerosis 240(1), 250–259 (2015). https://doi.org/10.1016/j.atherosclerosis.2015.03.026CrossRefPubMed

50.

M. Rattka, S. Westphal, B.M. Gahr, S. Just, W. Rottbauer, Spen deficiency interferes with Connexin 43 expression and leads to heart failure in zebrafish. J. Mol. Cell Cardiol. 155, 25–35 (2021). https://doi.org/10.1016/j.yjmcc.2021.01.006CrossRefPubMed

51.

A. Rodríguez-Sinovas, J.A. Sánchez, L. Valls-Lacalle, M. Consegal, I. Ferreira-González, Connexins in the heart: regulation, function and involvement in cardiac disease. Int. J. Mol. Sci. 22(9) (2021). https://doi.org/10.3390/ijms22094413

52.

M.S. Joshi, M.J. Mihm, A.C. Cook, B.L. Schanbacher, J.A. Bauer, Alterations in connexin 43 during diabetic cardiomyopathy: competition of tyrosine nitration versus phosphorylation. J. Diabetes 7(2), 250–259 (2015). https://doi.org/10.1111/1753-0407.12164CrossRefPubMed

53.

H. Lin, K. Ogawa, I. Imanaga, N. Tribulova, Remodeling of connexin 43 in the diabetic rat heart. Mol. Cell. Biochem. 290(1–2), 69–78 (2006). https://doi.org/10.1007/s11010-006-9166-yCrossRefPubMed

54.

S. Veeranki, S. Givvimani, S. Kundu, N. Metreveli, S. Pushpakumar, S.C. Tyagi, Moderate intensity exercise prevents diabetic cardiomyopathy associated contractile dysfunction through restoration of mitochondrial function and connexin 43 levels in db/db mice. J. Mol. Cell Cardiol. 92, 163–173 (2016). https://doi.org/10.1016/j.yjmcc.2016.01.023CrossRefPubMedPubMedCentral

55.

F.C. Howarth, N. Nowotny, E. Zilahi, M.A. El Haj, M. Lei, Altered expression of gap junction connexin proteins may partly underlie heart rhythm disturbances in the streptozotocin-induced diabetic rat heart. Mol. Cell. Biochem. 305(1-2), 145–151 (2007). https://doi.org/10.1007/s11010-007-9537-zCrossRefPubMed

56.

S. Poelzing, D.S. Rosenbaum, Altered connexin43 expression produces arrhythmia substrate in heart failure. Am. J. Physiol. Heart Circ. Physiol. 287(4), H1762–H1770 (2004)CrossRefPubMed

57.

D.E. Gutstein, G.E. Morley, D. Vaidya, F. Liu, F.L. Chen, H. Stuhlmann, G.I. Fishman, Heterogeneous expression of gap junction channels in the heart leads to conduction defects and ventricular dysfunction. Circulation 104(10), 1194–1199 (2001)CrossRefPubMed

58.

P. Kumarathurai, C. Anholm, B.S. Larsen, R.H. Olsen, S. Madsbad, O. Kristiansen, O.W. Nielsen, S.B. Haugaard, A. Sajadieh, Effects of liraglutide on heart rate and heart rate variability: a randomized, double-blind, placebo-controlled crossover study. Diabetes Care 40(1), 117–124 (2017). https://doi.org/10.2337/dc16-1580CrossRefPubMed

59.

Y.N. Guo, J.C. Wang, G.Y. Cai, X. Hu, S.Y. Cui, Y. Lv, Z. Yin, B. Fu, Q. Hong, X.M. Chen, AMPK-mediated downregulation of connexin43 and premature senescence of mesangial cells under high-glucose conditions. Exp. Gerontol. 51, 71–81 (2014). https://doi.org/10.1016/j.exger.2013.12.016CrossRefPubMed

60.

X. Li, L. Yu, J. Gao, X. Bi, J. Zhang, S. Xu, M. Wang, M. Chen, F. Qiu, G. Fu, Apelin ameliorates high glucose-induced downregulation of connexin 43 via ampk-dependent pathway in neonatal rat cardiomyocytes. Aging Dis. 9(1), 66–76 (2018). https://doi.org/10.14336/ad.2017.0426CrossRefPubMedPubMedCentral

61.

C.C. Lee, W.T. Chen, S.Y. Chen, T.M. Lee, Dapagliflozin attenuates arrhythmic vulnerabilities by regulating connexin43 expression via the AMPK pathway in post-infarcted rat hearts. Biochem. Pharmacol. 192, 114674 (2021). https://doi.org/10.1016/j.bcp.2021.114674CrossRefPubMed

Title: Semaglutide attenuates pathological electrophysiological remodeling in diabetic cardiomyopathy via restoring Cx43 expression
Authors: Meiling Yan
Kaibin Lin
Dong Huang
Jingbo Li
Xinkai Qu
Kankai Chen
Publication date: 22-04-2024
Publisher: Springer US
Keywords: Semaglutide
Diabetic Cardiomyopathy
Diabetes
Incretin Mimetics
Incretin Mimetics
Published in: Endocrine
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-024-03823-2

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

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

Pediatric Cardiology Video

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

Cardiopulmonary Comorbidity Video

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

Valvular Heart Disease Video

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

Heart Failure Video

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

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

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

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com