Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

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.
ADVANCED SEARCH
Log in
Top
Journal of Inflammation
Published in: Journal of Inflammation 1/2018

Open Access 01-12-2018 | Research

The impact of septic stimuli on the systemic inflammatory response and physiologic insult in a preclinical non-human primate model of polytraumatic injury

Authors: Diego A. Vicente, Matthew J. Bradley, Benjamin Bograd, Crystal Leonhardt, Eric A. Elster, Thomas A. Davis

Published in: Journal of Inflammation | Issue 1/2018

Login to get access

Abstract

Background

Established animal trauma models are limited in recapitulating the pathophysiology of human traumatic injury. Herein, we characterize the physiologic insult and inflammatory response in two clinically relevant non-human primate (NHP) trauma models.

Methods

Mauritian Cynomolgus Macaques underwent either a laparoscopic closed abdomen liver injury (laparoscopic 60% left-lobe hepatectomy) in an established uncontrolled severe hemorrhage model (THM), or a polytrauma hemorrhage model (PHM) involving combined liver and bowel injury, uncontrolled severe hemorrhage as well as an open full-thickness cutaneous flank wound. Fixed volume resuscitation strategies were employed in the THM and goal directed resuscitation was used in the PHM. Complete peripheral blood and critical clinical chemistry parameters, serum biomarkers of systemic inflammation, tissue perfusion parameters, as well as survival, were compared between the models throughout the 2-week study period.

Results

NHPs in both the THM (n = 7) and the PHM (n = 21) demonstrated tissue hypoperfusion (peak lactate 6.3 ± 0.71 mmol/L) with end organ injury (peak creatinine 3.08 ± 0.69 mg/dL) from a similar liver injury (60% left hemi-hepatectomy), though the PHM NHPs had a significantly higher blood loss (68.1% ± 12.7% vs. 34.3% ± 2.3%, p = 0.02), lower platelet counts (59 ± 25 vs. 205 ± 46 K/uL, p = 0.03) and a trend towards higher mortality (90.5% vs. 33.3%, p = 0.09). The inflammatory response was robust in both models with peak cytokine (IL-6 > 6000-fold above baseline) and peak leukocyte values (WBC 27 K/uL) typically occurring around t = 240 min from the time of hepatic injury. A more robust systemic inflammatory response was appreciated in the PHM resulting in marked elevations in peak serum IL-6 (7887 ± 2521 pg/mL vs.1076 ± 4833 pg/mL, p = 0.02), IL-1ra (34,499 ± 5987 pg/mL vs. 2511 ± 1228 pg/mL, p < 0.00), and IL-10 (13,411 pg/mL ± 5598 pg/mL vs. 617 pg/mL ± 252 pg/mL, p = 0.03).

Conclusion

This comparative analysis provides a unique longitudinal perspective on the post-injury inflammatory response in two clinically relevant models, and demonstrates that the addition of septic stimuli to solid organ injury increases both the hemorrhagic insult and inflammatory response.
Literature
1.
Kelly JF, Ritenour AE, McLaughlin DF, Bagg KA, Apodaca AN, Mallak CT, Pearse L, Lawnick MM, Champion HR, Wade CE, et al. Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003–2004 versus 2006. J Trauma. 2008;64(2 Suppl):S21–6. discussion S26–27CrossRefPubMed
2.
Eastridge BJ, Hardin M, Cantrell J, Oetjen-Gerdes L, Zubko T, Mallak C, Wade CE, Simmons J, Mace J, Mabry R, et al. Died of wounds on the battlefield: causation and implications for improving combat casualty care. J Trauma. 2011;71(1 Suppl):S4–8.CrossRefPubMed
3.
Kotwal RS, Montgomery HR, Kotwal BM, Champion HR, Butler FK Jr, Mabry RL, Cain JS, Blackbourne LH, Mechler KK, Holcomb JB. Eliminating preventable death on the battlefield. Arch Surg. 2011;146(12):1350–8.CrossRefPubMed
4.
Lisboa FA, Forsberg JA, Brown TS, Gage FA, Potter BK, Elster EA. Bilateral lower-extremity amputation wounds are associated with distinct local and systemic cytokine response. Surgery. 2013;154(2):282–90.CrossRefPubMed
5.
Potter BK, Burns TC, Lacap AP, Granville RR, Gajewski DA. Heterotopic ossification following traumatic and combat-related amputations. Prevalence, risk factors, and preliminary results of excision. J Bone Joint Surg Am. 2007;89(3):476–86.CrossRefPubMed
6.
Rodriguez CJ, Weintrob AC, Shah J, Malone D, Dunne JR, Weisbrod AB, Lloyd BA, Warkentien TE, Murray CK, Wilkins K, et al. Risk factors associated with invasive fungal infections in combat trauma. Surg Infect. 2014;15(5):521–6.CrossRef
7.
Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, Mallett O, Zubko T, Oetjen-Gerdes L, Rasmussen TE, et al. Death on the battlefield (2001-2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431–7.CrossRefPubMed
8.
Hutchison TN, Krueger CA, Berry JS, Aden JK, Cohn SM, White CE. Venous thromboembolism during combat operations: a 10-y review. J Surg Res. 2014;187(2):625–30.CrossRefPubMed
9.
Holley AB, Petteys S, Mitchell JD, Holley PR, Collen JF. Thromboprophylaxis and VTE rates in soldiers wounded in operation enduring freedom and operation Iraqi freedom. Chest. 2013;144(3):966–73.CrossRefPubMed
10.
Valparaiso AP, Vicente DA, Bograd BA, Elster EA, Davis TA. Modeling acute traumatic injury. J Surg Res. 2015;194(1):220–32.CrossRefPubMed
11.
Cannon JW, Hofmann LJ, Glasgow SC, Potter BK, Rodriguez CJ, Cancio LC, Rasmussen TE, Fries CA, Davis MR, Jezior JR, et al. Dismounted complex blast injuries: a comprehensive review of the modern combat experience. J Am Coll Surg. 2016;223(4):652–64. e658CrossRefPubMed
12.
Hazeldine J, Naumann DN, Toman E, Davies D, Bishop JRB, Su Z, Hampson P, Dinsdale RJ, Crombie N, Duggal NA, et al. Prehospital immune responses and development of multiple organ dysfunction syndrome following traumatic injury: a prospective cohort study. PLoS Med. 2017;14(7):e1002338.CrossRefPubMedCentralPubMed
13.
Seok J, Warren HS, Cuenca AG, Mindrinos MN, Baker HV, Xu W, Richards DR, GP MD-S, Gao H, Hennessy L, et al. Genomic responses in mouse models poorly mimic human inflammatory diseases. Proc Natl Acad Sci U S A. 2013;110(9):3507–12.CrossRefPubMedCentralPubMed
14.
Bograd BA, Radowsky JS, Vicente DA, Lee EH, Davis TA, Elster EA. An evolving uncontrolled hemorrhage model using Cynomolgus macaques. Shock. 2015;44(Suppl 1):123–8.CrossRefPubMed
15.
Bradley MJ, Vicente DA, Bograd BA, Sanders EM, Leonhardt CL, Elster EA, Davis TA. Host responses to concurrent combined injuries in non-human primates. J Inflamm (Lond). 2017;14:23.CrossRefPubMedCentral
16.
Trauma ACoSCo (ed.): ATLS advanced trauma life support for doctors, 9th edn: Chicago: American College of Surgeons; 2012.
17.
Ageyama N, Shibata H, Narita H, Hanari K, Kohno A, Ono F, Yoshikawa Y, Terao K. Specific gravity of whole blood in cynomolgus monkeys (Macaca fascicularis), squirrel monkeys (Saimiri sciureus), and tamarins (Saguinus labiatus) and total blood volume in cynomolgus monkeys. Contemp Top Lab Anim Sci. 2001;40(3):33–5.PubMed
18.
Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187–96.CrossRefPubMed
19.
Groeneveld KM, Koenderman L, Warren BL, Jol S, Leenen LPH, Hietbrink F. Early decreased neutrophil responsiveness is related to late onset sepsis in multitrauma patients: an international cohort study. PLoS One. 2017;12(6):e0180145.CrossRefPubMedCentralPubMed
20.
Kubiak BD, Albert SP, Gatto LA, Vieau CJ, Roy SK, Snyder KP, Maier KG, Nieman GF. A clinically applicable porcine model of septic and ischemia/reperfusion-induced shock and multiple organ injury. J Surg Res. 2011;166(1):e59–69.CrossRefPubMed
21.
Martin C, Boisson C, Haccoun M, Thomachot L, Mege JL. Patterns of cytokine evolution (tumor necrosis factor-alpha and interleukin-6) after septic shock, hemorrhagic shock, and severe trauma. Crit Care Med. 1997;25(11):1813–9.CrossRefPubMed
22.
Frith D, Cohen MJ, Brohi K. Animal models of trauma-induced coagulopathy. Thromb Res. 2012;129(5):551–6.CrossRefPubMed
23.
24.
Dhainaut JF, Shorr AF, Macias WL, Kollef MJ, Levi M, Reinhart K, Nelson DR. Dynamic evolution of coagulopathy in the first day of severe sepsis: relationship with mortality and organ failure. Crit Care Med. 2005;33(2):341–8.CrossRefPubMed
25.
26.
27.
28.
van Veen SQ, Levi M, van Vliet AK, Florquin S, van Gulik TM, Boermeester MA. Peritoneal lavage with activated protein C alters compartmentalized coagulation and fibrinolysis and improves survival in polymicrobial peritonitis. Crit Care Med. 2006;34(11):2799–805.CrossRefPubMed
29.
Kubiak BD, Albert SP, Gatto LA, Snyder KP, Maier KG, Vieau CJ, Roy S, Nieman GF. Peritoneal negative pressure therapy prevents multiple organ injury in a chronic porcine sepsis and ischemia/reperfusion model. Shock. 2010;34(5):525–34.CrossRefPubMed
30.
Kinasewitz GT, Chang AC, Peer GT, Hinshaw LB, Taylor FB Jr. Peritonitis in the baboon: a primate model which stimulates human sepsis. Shock. 2000;13(2):100–9.CrossRefPubMed
31.
32.
Brohi K, Cohen MJ, Ganter MT, Schultz MJ, Levi M, Mackersie RC, Pittet JF. Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma. 2008;64(5):1211–7. discussion 1217CrossRefPubMed
33.
Naumann DN, Hazeldine J, Davies DJ, Bishop J, Midwinter MJ, Belli A, Harrison P, Lord JM. Endotheliopathy of trauma is an on-scene phenomenon, and is associated with multiple organ dysfunction syndrome: a prospective observational study. Shock. 2017;49:420–8.
34.
Taylor FB Jr. Studies on the inflammatory-coagulant axis in the baboon response to E. coli: regulatory roles of proteins C, S, C4bBP and of inhibitors of tissue factor. Prog Clin Biol Res. 1994;388:175–94.PubMed
35.
Baker TA, Romero J, HHt B, Strom JA, Gamelli RL, Majetschak M. Systemic release of cytokines and heat shock proteins in porcine models of polytrauma and hemorrhage*. Crit Care Med. 2012;40(3):876–85.CrossRefPubMedCentralPubMed
36.
Kneidinger R, Bahrami S, Redl H, Schlag G, Robinson M. Comparison of endothelial activation during endotoxic and posttraumatic conditions by serum analysis of soluble E-selectin in nonhuman primates. J Lab Clin Med. 1996;128(5):515–9.CrossRefPubMed
37.
Patrick CJ, Berthot BD, Moore JD. Diazepam blocks fear-potentiated startle in humans. J Abnorm Psychol. 1996;105(1):89–96.CrossRefPubMed
38.
Namas R, Ghuma A, Torres A, Polanco P, Gomez H, Barclay D, Gordon L, Zenker S, Kim HK, Hermus L, et al. An adequately robust early TNF-alpha response is a hallmark of survival following trauma/hemorrhage. PLoS One. 2009;4(12):e8406.CrossRefPubMedCentralPubMed
39.
Arand M, Melzner H, Kinzl L, Bruckner UB, Gebhard F. Early inflammatory mediator response following isolated traumatic brain injury and other major trauma in humans. Langenbeck's Arch Surg. 2001;386(4):241–8.CrossRef
40.
Jastrow KM 3rd, Gonzalez EA, McGuire MF, Suliburk JW, Kozar RA, Iyengar S, Motschall DA, McKinley BA, Moore FA, Mercer DW. Early cytokine production risk stratifies trauma patients for multiple organ failure. J Am Coll Surg. 2009;209(3):320–31.CrossRefPubMed
41.
Deitch EA, Forsythe R, Anjaria D, Livingston DH, Lu Q, Xu DZ, Redl H. The role of lymph factors in lung injury, bone marrow suppression, and endothelial cell dysfunction in a primate model of trauma-hemorrhagic shock. Shock. 2004;22(3):221–8.CrossRefPubMed
42.
Binkowska AM, Michalak G, Slotwinski R. Current views on the mechanisms of immune responses to trauma and infection. Cent Eur J Immunol. 2015;40(2):206–16.CrossRefPubMedCentralPubMed
43.
Sheppard FR, Macko AR, Glaser JJ, Vernon PJ, Burdette AJ, Paredes RM, Koeller CA, Pusateri AE, Tadaki DK, Cardin S. Non-human primate (rhesus macaque) models of severe pressure-targeted hemorrhagic and poly-traumatic hemorrhagic shock. Shock. 2017. https://​doi.​org/​10.​1097/​SHK.​0000000000000910​. [Epub ahead of print]
44.
Partrick DA, Moore FA, Moore EE, Biffl WL, Sauaia A, Barnett CC Jr, Jack A. Barney Resident Research Award winner. The inflammatory profile of interleukin-6, interleukin-8, and soluble intercellular adhesion molecule-1 in postinjury multiple organ failure. Am J Surg. 1996;172(5):425–9. discussed 429–431CrossRefPubMed
45.
Maier B, Lefering R, Lehnert M, Laurer HL, Steudel WI, Neugebauer EA, Marzi I. Early versus late onset of multiple organ failure is associated with differing patterns of plasma cytokine biomarker expression and outcome after severe trauma. Shock. 2007;28(6):668–74.PubMed
46.
Neidhardt R, Keel M, Steckholzer U, Safret A, Ungethuem U, Trentz O, Ertel W. Relationship of interleukin-10 plasma levels to severity of injury and clinical outcome in injured patients. J Trauma. 1997;42(5):863–70. discussion 870-861CrossRefPubMed
47.
Roumen RM, Hendriks T, van der Ven-Jongekrijg J, Nieuwenhuijzen GA, Sauerwein RW, van der Meer JW, Goris RJ. Cytokine patterns in patients after major vascular surgery, hemorrhagic shock, and severe blunt trauma. Relation with subsequent adult respiratory distress syndrome and multiple organ failure. Ann Surg. 1993;218(6):769–76.CrossRefPubMedCentralPubMed
48.
Hawksworth JS, Stojadinovic A, Gage FA, Tadaki DK, Perdue PW, Forsberg J, Davis TA, Dunne JR, Denobile JW, Brown TS, et al. Inflammatory biomarkers in combat wound healing. Ann Surg. 2009;250(6):1002–7.CrossRefPubMed
49.
Hildebrand F, Andruszkow H, Huber-Lang M, Pape HC, van Griensven M. Combined hemorrhage/trauma models in pigs-current state and future perspectives. Shock. 2013;40(4):247–73.CrossRefPubMed
50.
Redl H SG, Paul E, Davies J. Monocyte/macrophage activation with cytokine release after polytrauma and sepsis in the baboon. Circ Shock. 1989;27(308).
51.
Ayala A, Wang P, Ba ZF, Perrin MM, Ertel W, Chaudry IH. Differential alterations in plasma IL-6 and TNF levels after trauma and hemorrhage. Am J Phys. 1991;260(1 Pt 2):R167–71.
52.
Romeo C, Cruccetti A, Turiaco A, Impellizzeri P, Turiaco N, Di Bella C, Merlino MV, Cifala S, Basile M, Gentile C, et al. Monocyte and neutrophil activity after minor surgical stress. J Pediatr Surg. 2002;37(5):741–4.CrossRefPubMed
53.
Glaser F, Sannwald GA, Buhr HJ, Kuntz C, Mayer H, Klee F, Herfarth C. General stress response to conventional and laparoscopic cholecystectomy. Ann Surg. 1995;221(4):372–80.CrossRefPubMedCentralPubMed
54.
Cruickshank AM, Fraser WD, Burns HJ, Van Damme J, Shenkin A. Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci (Lond). 1990;79(2):161–5.CrossRef
55.
Kloosterman T, von Blomberg BM, Borgstein P, Cuesta MA, Scheper RJ, Meijer S. Unimpaired immune functions after laparoscopic cholecystectomy. Surgery. 1994;115(4):424–8.PubMed
56.
Foex BA, Lamb WR, Roberts TE, Brear SG, Macartney I, Hammer M, Brenchley PE. Early cytokine response to multiple injury. Injury. 1993;24(6):373–6.CrossRefPubMed
57.
Wu HP, Chen CK, Chung K, Tseng JC, Hua CC, Liu YC, Chuang DY, Yang CH. Serial cytokine levels in patients with severe sepsis. Inflamm Res. 2009;58(7):385–93.CrossRefPubMed
58.
Heffernan DS, Monaghan SF, Thakkar RK, Machan JT, Cioffi WG, Ayala A. Failure to normalize lymphopenia following trauma is associated with increased mortality, independent of the leukocytosis pattern. Crit Care. 2012;16(1):R12.CrossRefPubMedCentralPubMed
59.
Cheadle WG, Pemberton RM, Robinson D, Livingston DH, Rodriguez JL, Polk HC Jr. Lymphocyte subset responses to trauma and sepsis. J Trauma. 1993;35(6):844–9.CrossRefPubMed
60.
Aguilar MM, Battistella FD, Owings JT, Olson SA, MacColl K. Posttraumatic lymphocyte response: a comparison between peripheral blood T cells and tissue T cells. J Trauma. 1998;45(1):14–8.CrossRefPubMed
61.
Berenbaum MC, Fluck PA, Hurst NP. Depression of lymphocyte responses after surgical trauma. Br J Exp Pathol. 1973;54(6):597–607.PubMedCentralPubMed
62.
Xu YX, Ayala A, Chaudry IH. Prolonged immunodepression after trauma and hemorrhagic shock. J Trauma. 1998;44(2):335–41.CrossRefPubMed
63.
Bandyopadhyay G, De A, Laudanski K, Li F, Lentz C, Bankey P, Miller-Graziano C. Negative signaling contributes to T-cell anergy in trauma patients. Crit Care Med. 2007;35(3):794–801.CrossRefPubMed
64.
Puyana JC, Pellegrini JD, De AK, Kodys K, Silva WE, Miller CL. Both T-helper-1- and T-helper-2-type lymphokines are depressed in posttrauma anergy. J Trauma. 1998;44(6):1037–45. discussion 1045-1036CrossRefPubMed
65.
Venet F, Chung CS, Huang X, Lomas-Neira J, Chen Y, Ayala A. Lymphocytes in the development of lung inflammation: a role for regulatory CD4+ T cells in indirect pulmonary lung injury. J Immunol. 2009;183(5):3472–80.CrossRefPubMed
66.
Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratislavske lekarske listy. 2001;102(1):5–14.PubMed
67.
Menges T, Engel J, Welters I, Wagner RM, Little S, Ruwoldt R, Wollbrueck M, Hempelmann G. Changes in blood lymphocyte populations after multiple trauma: association with posttraumatic complications. Crit Care Med. 1999;27(4):733–40.CrossRefPubMed
68.
Chen ZY, Raghav K, Lieu CH, Jiang ZQ, Eng C, Vauthey JN, Chang GJ, Qiao W, Morris J, Hong D, et al. Cytokine profile and prognostic significance of high neutrophil-lymphocyte ratio in colorectal cancer. Br J Cancer. 2015;112(6):1088–97.CrossRefPubMedCentralPubMed
69.
Yamada R, Tsuchida S, Hara Y, Tagawa M, Ogawa R. Apoptotic lymphocytes induced by surgical trauma in dogs. J Anesth. 2002;16(2):131–7.CrossRefPubMed
70.
Duke SS, Guerry-Force ML, Forbes JT, Stewart SJ, King G, Wickersham N, Brigham KL, Meyrick B. Acute endotoxin-induced lymphocyte subset sequestration in sheep lungs. Lab Investig. 1990;62(3):355–62.PubMed
71.
Jones M, Hoover R, Meyrick B. Endotoxin enhancement of lymphocyte adherence to cultured sheep lung microvascular endothelial cells. Am J Respir Cell Mol Biol. 1992;7(1):81–9.CrossRefPubMed
72.
Sharma SK, MacLean JA, Pinto C, Kradin RL. The effect of an anti-CD3 monoclonal antibody on bleomycin-induced lymphokine production and lung injury. Am J Respir Crit Care Med. 1996;154(1):193–200.CrossRefPubMed
73.
Duchesne JC, Tatum D, Jones G, Davis B, Robledo R, DeMoya M, O'Keeffe T, Ferrada P, Jacome T, Schroll R, et al. Multi-institutional analysis of neutrophil-to-lymphocyte ratio (NLR) in patients with severe hemorrhage: a new mortality predictor value. J Trauma Acute Care Surg. 2017;83(5):888–93.CrossRefPubMed
Metadata
Title
The impact of septic stimuli on the systemic inflammatory response and physiologic insult in a preclinical non-human primate model of polytraumatic injury
Authors
Diego A. Vicente
Matthew J. Bradley
Benjamin Bograd
Crystal Leonhardt
Eric A. Elster
Thomas A. Davis
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Inflammation / Issue 1/2018
Electronic ISSN: 1476-9255
DOI
https://doi.org/10.1186/s12950-018-0187-6

Other articles of this Issue 1/2018

Journal of Inflammation 1/2018 Go to the issue

Research

CXCR-4 expression by circulating endothelial progenitor cells and SDF-1 serum levels are elevated in septic patients

Research

Experimental murine acute lung injury induces increase of pulmonary TIE2-expressing macrophages

Research

Zymosan attenuates melanoma growth progression, increases splenocyte proliferation and induces TLR-2/4 and TNF-α expression in mice

Research

Interleukin-10 attenuates impairment of the blood-brain barrier in a severe acute pancreatitis rat model

Research

Dynamics of soluble vascular endothelial growth factor receptors and their ligands in aqueous humour during ranibizumab for age-related macular degeneration

Research

Transient receptor potential ankyrin 1 (trpa1) mediates il-1β-induced apoptosis in rat chondrocytes via calcium overload and mitochondrial dysfunction
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

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 discuss 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 discuss 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