Skip to main content
Top
Published in: Journal of Translational Medicine 1/2016

Open Access 01-12-2016 | Research

The magnitude of nephron number reduction mediates intrauterine growth-restriction-induced long term chronic renal disease in the rat. A comparative study in two experimental models

Authors: Farid Boubred, Laurent Daniel, Christophe Buffat, Michel Tsimaratos, Charles Oliver, Martine Lelièvre-Pégorier, Umberto Simeoni

Published in: Journal of Translational Medicine | Issue 1/2016

Login to get access

Abstract

Background

Intrauterine growth restriction (IUGR) is a risk factor for hypertension (HT) and chronic renal disease (CRD). A reduction in the nephron number is proposed to be the underlying mechanism; however, the mechanism is debated. The aim of this study was to demonstrate that IUGR-induced HT and CRD are linked to the magnitude of nephron number reduction, independently on its cause.

Methods

Systolic blood pressure (SBP), glomerular filtration rate (GFR), proteinuria, nephron number, and glomerular sclerosis were compared between IUGR offspring prenatally exposed to a maternal low-protein diet (9% casein; LPD offspring) or maternal administration of betamethasone (from E17 to E19; BET offspring) and offspring with a normal birth weight (NBW offspring).

Results

Both prenatal interventions led to IUGR and a similar reduction in birth weight. In comparison to NBW offspring, BET offspring had a severe nephron deficit (−50% in males and −40% in females, p < 0.01), an impaired GFR (−33%, p < 0.05), and HT (SBP+ 17 mmHg, p < 0.05). Glomerular sclerosis was more than twofold higher in BET offspring than in NBW offspring (p < 0.05). Long-term SBP, GFR, and glomerular sclerosis were unchanged in LPD offspring while the nephron number was moderately reduced only in males (−28% vs. NBW offspring, p < 0.05).

Conclusion

In this study, the magnitude of nephron number reduction influences long term renal disease in IUGR offspring: a moderate nephron number is an insufficient factor. Extremely long-term follow-up of adults prenatally exposed to glucocorticoids are required.
Literature
1.
go back to reference Barker DJP, Osmond C, Golding J, Kuh D, Wadsworth MEJ. Growth in utero, blood pressure in childhood and adult life, and mortality from cardio-vascular disease. Br Med J. 1989;298:564–7.CrossRef Barker DJP, Osmond C, Golding J, Kuh D, Wadsworth MEJ. Growth in utero, blood pressure in childhood and adult life, and mortality from cardio-vascular disease. Br Med J. 1989;298:564–7.CrossRef
2.
go back to reference Vehaskari VM, Woods LL. Prenatal programming of hypertension: lessons from experimental models. J Am Soc Nephrol. 2005;16:254–6.CrossRef Vehaskari VM, Woods LL. Prenatal programming of hypertension: lessons from experimental models. J Am Soc Nephrol. 2005;16:254–6.CrossRef
3.
4.
go back to reference Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. J Am Med Assoc. 2007;298:2038–47.CrossRef Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. J Am Med Assoc. 2007;298:2038–47.CrossRef
5.
go back to reference McDonald TJ, Franko KL, Brown JM, Jenkins SL, Nathanielsz PW, Nijland MJ. Betamethasone in the last week of pregnancy causes fetal growth retardation but nor adult hypertension in rats. J Soc Gynecol Invest. 2003;10:469–73.CrossRef McDonald TJ, Franko KL, Brown JM, Jenkins SL, Nathanielsz PW, Nijland MJ. Betamethasone in the last week of pregnancy causes fetal growth retardation but nor adult hypertension in rats. J Soc Gynecol Invest. 2003;10:469–73.CrossRef
6.
go back to reference Hoppe CC, Evans RG, Moritz KM, Kullen-McEwen LA, Fitzgerald SM, Dowling J, Bertram JF. Combined prenatal and postnatal protein restriction influences adult kidney structure, function, and arterial pressure. Am J Physiol Regul Integr Comp Physiol. 2007;292:R462–9.CrossRefPubMed Hoppe CC, Evans RG, Moritz KM, Kullen-McEwen LA, Fitzgerald SM, Dowling J, Bertram JF. Combined prenatal and postnatal protein restriction influences adult kidney structure, function, and arterial pressure. Am J Physiol Regul Integr Comp Physiol. 2007;292:R462–9.CrossRefPubMed
7.
go back to reference Bramlage CP, Schlumbohm C, Pryce CR, Mirza S, Schnell C, Amann K, Amstrong VW, Eitner F, Zapf A, Feldon J, Oellerich M, Fuchs E, Mühle A, Stritz F. Prenatal dexamethasone exposure does not alter blood pressure and nephron number in the young adult marmoset monkey. Hypertension. 2009;54:1115–22.CrossRefPubMed Bramlage CP, Schlumbohm C, Pryce CR, Mirza S, Schnell C, Amann K, Amstrong VW, Eitner F, Zapf A, Feldon J, Oellerich M, Fuchs E, Mühle A, Stritz F. Prenatal dexamethasone exposure does not alter blood pressure and nephron number in the young adult marmoset monkey. Hypertension. 2009;54:1115–22.CrossRefPubMed
8.
go back to reference Moritz KM, Mazzuca MQ, Siebel AL, Mibus A, Tare M, Owens JA, Wlodek ME. Uteroplacental insufficiency causes a nephron deficit, modest renal insufficiency but no hypertension with ageing in female rats. J Physiol. 2009;587:2635–46.CrossRefPubMedPubMedCentral Moritz KM, Mazzuca MQ, Siebel AL, Mibus A, Tare M, Owens JA, Wlodek ME. Uteroplacental insufficiency causes a nephron deficit, modest renal insufficiency but no hypertension with ageing in female rats. J Physiol. 2009;587:2635–46.CrossRefPubMedPubMedCentral
9.
go back to reference Seckl JR, Holmes MC. Mechanisms of disease: glucocorticoids, their placenta metabolism and fetal “programming” of adult disease. Nat Clin Pract Endocrinol Metab. 2007;3:479–88.CrossRefPubMed Seckl JR, Holmes MC. Mechanisms of disease: glucocorticoids, their placenta metabolism and fetal “programming” of adult disease. Nat Clin Pract Endocrinol Metab. 2007;3:479–88.CrossRefPubMed
10.
go back to reference Paolini CL, Marconi AM, Ronzoni S, Di Noio M, Fennessey PV, Pardi G, Battaglia FC. Placental transport of leucine, phenylalanine, glycine, and proline in intrauterine growth-restricted pregnancies. J Clin Endocrinol Metab. 2001;86:5427–32.CrossRefPubMed Paolini CL, Marconi AM, Ronzoni S, Di Noio M, Fennessey PV, Pardi G, Battaglia FC. Placental transport of leucine, phenylalanine, glycine, and proline in intrauterine growth-restricted pregnancies. J Clin Endocrinol Metab. 2001;86:5427–32.CrossRefPubMed
11.
go back to reference Jansson N, Pettersson J, Haafiz A, Ericsson A, Palmberg I, Tranberg M, Ganapathy V, Powell TL, Jansson T. Down-regulation of placental transport of amino acids precedes the development of intrauterine growth restriction in rats fed a low protein diet. J Physiol. 2006;576:935–46.PubMedPubMedCentral Jansson N, Pettersson J, Haafiz A, Ericsson A, Palmberg I, Tranberg M, Ganapathy V, Powell TL, Jansson T. Down-regulation of placental transport of amino acids precedes the development of intrauterine growth restriction in rats fed a low protein diet. J Physiol. 2006;576:935–46.PubMedPubMedCentral
12.
go back to reference Brenner BM, Chertow GM. Congenital oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis. 1994;3:171–5.CrossRef Brenner BM, Chertow GM. Congenital oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis. 1994;3:171–5.CrossRef
13.
go back to reference Bagby SP. Maternal nutrition, low nephron number, and hypertension in later life: pathways of nutritional programming. J Nutr. 2007;137:1066–72.PubMed Bagby SP. Maternal nutrition, low nephron number, and hypertension in later life: pathways of nutritional programming. J Nutr. 2007;137:1066–72.PubMed
14.
go back to reference Brenner BM, Garcia DL, Anderson S. Glomeruli and blood pressure. less of one, more the other. Am J Hypertens. 1988;1:335–47.CrossRefPubMed Brenner BM, Garcia DL, Anderson S. Glomeruli and blood pressure. less of one, more the other. Am J Hypertens. 1988;1:335–47.CrossRefPubMed
15.
go back to reference Martins JP, Monteiro JC, Paixao AD. Renal function in adult rats subjected to prenatal dexamethsaone. Clin Exp Pharmacol Physiol. 2003;30:32–7.CrossRefPubMed Martins JP, Monteiro JC, Paixao AD. Renal function in adult rats subjected to prenatal dexamethsaone. Clin Exp Pharmacol Physiol. 2003;30:32–7.CrossRefPubMed
16.
go back to reference Zimanyi MA, Denton KM, Forbes JM, Thallas-Bonke V, Thomas MC, Poon F, Black MJ. A developmental nephron deficit in rats is associated with increased susceptibility to a secondary renal injury due to advanced glycation end-products. Diabetologia. 2006;49:801–10.CrossRefPubMed Zimanyi MA, Denton KM, Forbes JM, Thallas-Bonke V, Thomas MC, Poon F, Black MJ. A developmental nephron deficit in rats is associated with increased susceptibility to a secondary renal injury due to advanced glycation end-products. Diabetologia. 2006;49:801–10.CrossRefPubMed
17.
go back to reference Brennan KA, Kaufman S, Reynolds SW, McCook BT, Kan G, Christiaens I, Symonds ME, Olson DM. Differential effects of maternal nutrient restriction through pregnancy on kidney development and later blood pressure control in the resulting offspring. Am J Physiol Regul Integr Comp Physiol. 2008;295:R197–205.CrossRefPubMedPubMedCentral Brennan KA, Kaufman S, Reynolds SW, McCook BT, Kan G, Christiaens I, Symonds ME, Olson DM. Differential effects of maternal nutrient restriction through pregnancy on kidney development and later blood pressure control in the resulting offspring. Am J Physiol Regul Integr Comp Physiol. 2008;295:R197–205.CrossRefPubMedPubMedCentral
18.
go back to reference Boubred F, Daniel L, Buffat C, Feuerstein JM, Tsimaratos M, Oliver C, Dignat-George F, Lelievre-Pegorier M, Simeoni U. Early postnatal overfeeding induces early chronic renal dysfunction in adult male rats. Am J Physiol Renal Physiol. 2009;297:F943–51.CrossRefPubMed Boubred F, Daniel L, Buffat C, Feuerstein JM, Tsimaratos M, Oliver C, Dignat-George F, Lelievre-Pegorier M, Simeoni U. Early postnatal overfeeding induces early chronic renal dysfunction in adult male rats. Am J Physiol Renal Physiol. 2009;297:F943–51.CrossRefPubMed
19.
go back to reference Ruta LA, Dickinson H, Thomas MC, Dickinson KM, Anderson WP, Kett MM. High salt diet reveals the hypertensive and renal effects of reduced nephron endowment. Am J Physiol Renal Physiol. 2010;298:F1384–92.CrossRefPubMed Ruta LA, Dickinson H, Thomas MC, Dickinson KM, Anderson WP, Kett MM. High salt diet reveals the hypertensive and renal effects of reduced nephron endowment. Am J Physiol Renal Physiol. 2010;298:F1384–92.CrossRefPubMed
20.
go back to reference Boubred F, Buffat C, Feuerstein JM, Daniel L, Tsimaratos M, Oliver C, Lelievre-Pegorier M, Simeoni U. Effects of early hypernutrition on nephron number and long term renal functions and structure in rats. Am J Physiol Renal Physiol. 2007;293:F1944–9.CrossRefPubMed Boubred F, Buffat C, Feuerstein JM, Daniel L, Tsimaratos M, Oliver C, Lelievre-Pegorier M, Simeoni U. Effects of early hypernutrition on nephron number and long term renal functions and structure in rats. Am J Physiol Renal Physiol. 2007;293:F1944–9.CrossRefPubMed
21.
go back to reference Woods LL, Ingelfinger JR, Rasch R. Modest maternal protein restriction fails to program adult hypertension in female rats. Am J Physiol Regul Integr Comp Physiol. 2005;289:R1131–6.CrossRefPubMed Woods LL, Ingelfinger JR, Rasch R. Modest maternal protein restriction fails to program adult hypertension in female rats. Am J Physiol Regul Integr Comp Physiol. 2005;289:R1131–6.CrossRefPubMed
22.
go back to reference Ortiz LA, Ouan A, Zarzar F, Weinberg A, Baum M. Prenatal dexamethasone programs hypertension and renal injury in the rat. Hypertension. 2003;41:328–34.CrossRefPubMedPubMedCentral Ortiz LA, Ouan A, Zarzar F, Weinberg A, Baum M. Prenatal dexamethasone programs hypertension and renal injury in the rat. Hypertension. 2003;41:328–34.CrossRefPubMedPubMedCentral
23.
go back to reference Woods LL, Weeks DA. Prenatal programming of adult blood pressure: role of maternal corticosteroids. Am J Physiol Integr Comp Physiol. 2005;289:R955–62.CrossRef Woods LL, Weeks DA. Prenatal programming of adult blood pressure: role of maternal corticosteroids. Am J Physiol Integr Comp Physiol. 2005;289:R955–62.CrossRef
24.
go back to reference Welham SJ, Riley PR, Wade A, Hubank M, Woolf AS. Maternal diet programs embryonic kidney gene expression. Physiol Genomics. 2005;22:48–56.CrossRefPubMed Welham SJ, Riley PR, Wade A, Hubank M, Woolf AS. Maternal diet programs embryonic kidney gene expression. Physiol Genomics. 2005;22:48–56.CrossRefPubMed
25.
go back to reference Dickinson H, Walker DW, Wintour EM, Moritz K. Maternal dexamethasone treatment at mid gestation reduces nephron number and alters gene expression in fetal spiny mouse. Am J Physiol Integr Comp Physiol. 2007;292:R453–61.CrossRef Dickinson H, Walker DW, Wintour EM, Moritz K. Maternal dexamethasone treatment at mid gestation reduces nephron number and alters gene expression in fetal spiny mouse. Am J Physiol Integr Comp Physiol. 2007;292:R453–61.CrossRef
26.
go back to reference Singh RR, Moritz KM, Bertram JF, Cullen-McEwen LA. Effects of dexamethasone exposure on metanephric development: in vitro and in vivo studies. Am J Physiol Renal Physiol. 2007;293:F548–54.CrossRefPubMed Singh RR, Moritz KM, Bertram JF, Cullen-McEwen LA. Effects of dexamethasone exposure on metanephric development: in vitro and in vivo studies. Am J Physiol Renal Physiol. 2007;293:F548–54.CrossRefPubMed
27.
go back to reference Abdel-Hakeem AK, Henry TQ, Magee TR, Desai M, Ross MG, Mansano RZ, Today JS, Nast CC. Mechanisms of impaired nephrogenesis with fetal growth restriction: altered renal transcription and growth factor expression. Am J Obstet Gynecol. 2008;199(252):e1–7. Abdel-Hakeem AK, Henry TQ, Magee TR, Desai M, Ross MG, Mansano RZ, Today JS, Nast CC. Mechanisms of impaired nephrogenesis with fetal growth restriction: altered renal transcription and growth factor expression. Am J Obstet Gynecol. 2008;199(252):e1–7.
28.
go back to reference Buffat C, Boubred F, Mondon F, Bessières B, Fayol L, Feuerstein JM, Gamerre M, Jammes H, Recourbet R, Miralles F, Courbieres B, Basire A, Dignat-George F, Carbonne B, Simeoni U, Vaiman D. Kidney gene expression analysis in a rat model of intrauterine growth restriction reveals massive alterations of coagulation genes. Endocrinology. 2007;148:5549–57.CrossRefPubMed Buffat C, Boubred F, Mondon F, Bessières B, Fayol L, Feuerstein JM, Gamerre M, Jammes H, Recourbet R, Miralles F, Courbieres B, Basire A, Dignat-George F, Carbonne B, Simeoni U, Vaiman D. Kidney gene expression analysis in a rat model of intrauterine growth restriction reveals massive alterations of coagulation genes. Endocrinology. 2007;148:5549–57.CrossRefPubMed
29.
go back to reference Habib S, Gattineni J, Twombley K, Baum M. Evidence that prenatal programming of hypertension by dietary protein deprivation is mediated by fetal glucocorticoids exposure. Am J Hypertens. 2011;24:96–101.CrossRefPubMed Habib S, Gattineni J, Twombley K, Baum M. Evidence that prenatal programming of hypertension by dietary protein deprivation is mediated by fetal glucocorticoids exposure. Am J Hypertens. 2011;24:96–101.CrossRefPubMed
30.
go back to reference Luyckx VA, Bertram JF, Brenner BM, Fall C, Hoy WE, Ozanne SE, Vikse BE. Effect of fetal and child health on kidney development and long-term risk of hypertension and kidney disease. Lancet. 2013;382:273–83.CrossRefPubMed Luyckx VA, Bertram JF, Brenner BM, Fall C, Hoy WE, Ozanne SE, Vikse BE. Effect of fetal and child health on kidney development and long-term risk of hypertension and kidney disease. Lancet. 2013;382:273–83.CrossRefPubMed
32.
go back to reference Leh S, Hultström M, Rosenberger C, Iversen BM. Afferent arteriolopathy and glomerular collapse but not segmental sclerosis induce tubular atrophy in old spontaneously hypertensive rats. Virchows Arch. 2011;459:99–108.CrossRefPubMedPubMedCentral Leh S, Hultström M, Rosenberger C, Iversen BM. Afferent arteriolopathy and glomerular collapse but not segmental sclerosis induce tubular atrophy in old spontaneously hypertensive rats. Virchows Arch. 2011;459:99–108.CrossRefPubMedPubMedCentral
33.
go back to reference O’Regan D, Kenyon CJ, Seckl JR, Holmes MC. Prenatal dexamethasone “programmes” hypotension, but stress-induced hypertension in adult offspring. J Endocrinol. 2008;196:343–52.CrossRefPubMedPubMedCentral O’Regan D, Kenyon CJ, Seckl JR, Holmes MC. Prenatal dexamethasone “programmes” hypotension, but stress-induced hypertension in adult offspring. J Endocrinol. 2008;196:343–52.CrossRefPubMedPubMedCentral
34.
go back to reference Augustyniak RA, Singh K, Zeldes D, Singh M, Rossi NF. Maternal protein restriction leads to hyper-responsiveness to stress and salt-sensitive hypertension in male offspring. Am J Phsyiol Regul Integr Comp Physiol. 2010;298:R1375–82.CrossRef Augustyniak RA, Singh K, Zeldes D, Singh M, Rossi NF. Maternal protein restriction leads to hyper-responsiveness to stress and salt-sensitive hypertension in male offspring. Am J Phsyiol Regul Integr Comp Physiol. 2010;298:R1375–82.CrossRef
35.
go back to reference Ligi I, Grandvuillemin I, Andres V, Dignat-George F, Simeoni U. Low birth weight infants and the developmental programming of hypertension: a focus on vascular factors. Semin Perinatol. 2010;34:188–92.CrossRefPubMed Ligi I, Grandvuillemin I, Andres V, Dignat-George F, Simeoni U. Low birth weight infants and the developmental programming of hypertension: a focus on vascular factors. Semin Perinatol. 2010;34:188–92.CrossRefPubMed
36.
go back to reference Moisiadis VG, Matthews SG. Glucocorticoids and fetal programming part 1: outcomes. Nat Rev Endocrinol. 2014;10:391–402.CrossRefPubMed Moisiadis VG, Matthews SG. Glucocorticoids and fetal programming part 1: outcomes. Nat Rev Endocrinol. 2014;10:391–402.CrossRefPubMed
37.
go back to reference Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A. Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. The Vermont Oxford Network. Am J Obstet Gynecol. 2000;182:198–206.CrossRefPubMed Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A. Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. The Vermont Oxford Network. Am J Obstet Gynecol. 2000;182:198–206.CrossRefPubMed
38.
go back to reference Wapner RJ, Sorokin Y, Mele L, Johnson F, Dudley DJ, Spong CY, Peaceman AM, Leveno KJ, Malone F, Caritis SN, Mercer B, Harper M, Rouse DJ, Thorp JM, Ramin S, Carpenter MW, Gabbe SG, National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Long-term outcomes after repeat doses of antenatal corticosteroids. N Engl J Med. 2007;357:1190–8.CrossRefPubMed Wapner RJ, Sorokin Y, Mele L, Johnson F, Dudley DJ, Spong CY, Peaceman AM, Leveno KJ, Malone F, Caritis SN, Mercer B, Harper M, Rouse DJ, Thorp JM, Ramin S, Carpenter MW, Gabbe SG, National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Long-term outcomes after repeat doses of antenatal corticosteroids. N Engl J Med. 2007;357:1190–8.CrossRefPubMed
39.
go back to reference Dalziel S, Walker NK, Parag V, Mantell C, Rea HH, Rodgers A, Harding JE. Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial. Lancet. 2005;365:1856–62.CrossRefPubMed Dalziel S, Walker NK, Parag V, Mantell C, Rea HH, Rodgers A, Harding JE. Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial. Lancet. 2005;365:1856–62.CrossRefPubMed
40.
go back to reference Finken MJJ, Keijzer-Veen MG, Dekker FW, Frölich M, Walther FJ, Romijn JA, van der Heijden BJ, Wit JM. Antenatal glucocorticoid treatment is not associated with long term metabolic risks in individuals born before 32 weeks of gestation. Arch Dis Chil Fetal Neonatal Ed. 2008;93:F442–7.CrossRef Finken MJJ, Keijzer-Veen MG, Dekker FW, Frölich M, Walther FJ, Romijn JA, van der Heijden BJ, Wit JM. Antenatal glucocorticoid treatment is not associated with long term metabolic risks in individuals born before 32 weeks of gestation. Arch Dis Chil Fetal Neonatal Ed. 2008;93:F442–7.CrossRef
41.
go back to reference Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2006;19(3):04454. Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2006;19(3):04454.
Metadata
Title
The magnitude of nephron number reduction mediates intrauterine growth-restriction-induced long term chronic renal disease in the rat. A comparative study in two experimental models
Authors
Farid Boubred
Laurent Daniel
Christophe Buffat
Michel Tsimaratos
Charles Oliver
Martine Lelièvre-Pégorier
Umberto Simeoni
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2016
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-016-1086-3

Other articles of this Issue 1/2016

Journal of Translational Medicine 1/2016 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.