Skip to main content
Top
Published in: Endocrine 2/2016

01-05-2016 | Editorial

Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy?

Authors: G. Mazziotti, F. Maffezzoni, A. Giustina

Published in: Endocrine | Issue 2/2016

Login to get access

Excerpt

In only 5 years, more than 20,000 papers (more than 300 in the last month) dealing with vitamin D have been published, reflecting the deep interest of the scientific community for the role of this hormone in health and disease. As a matter of fact, vitamin D has been shown to exert pleiotropic effects on different tissues and there has been growing evidence that low vitamin D may be associated with several pathological conditions, including fragility fractures [1], myopathy [2], diabetes [3], cardiovascular [4], autoimmune [5], and neoplastic diseases [6]. Despite this compelling evidence, there is still controversy on how hypovitaminosis D should be evaluated and defined in different clinical settings and whether and how supplementation of vitamin D deficiency may truly influence the different clinical outcomes. …
Literature
1.
go back to reference J.A. Cauley, A.Z. LaCroix, L. Wu, M. Horwitz, M.E. Danielson, D.C. Bauer, J.S. Lee, R.D. Jackson, J.A. Robbins, C. Wu, F.Z. Stanczyk, M.S. LeBoff, J. Wactawski-Wende, G. Sarto, J. Ockene, S.R. Cummings, Serum 25 hydroxyvitamin D concentrations and the risk of hip fractures: the women’s health initiative. Ann Intern. Med. 149, 242–250 (2008)CrossRefPubMedPubMedCentral J.A. Cauley, A.Z. LaCroix, L. Wu, M. Horwitz, M.E. Danielson, D.C. Bauer, J.S. Lee, R.D. Jackson, J.A. Robbins, C. Wu, F.Z. Stanczyk, M.S. LeBoff, J. Wactawski-Wende, G. Sarto, J. Ockene, S.R. Cummings, Serum 25 hydroxyvitamin D concentrations and the risk of hip fractures: the women’s health initiative. Ann Intern. Med. 149, 242–250 (2008)CrossRefPubMedPubMedCentral
2.
go back to reference L.M. Cangussu, J. Nahas-Neto, C.L. Orsatti, F.N. Bueloni-Dias, E.A. Nahas, Effect of vitamin D supplementation alone on muscle function in postmenopausal women: a randomized, double-blind, placebo-controlled clinical trial. Osteoporos. Int. 26, 2413–2421 (2015)CrossRefPubMed L.M. Cangussu, J. Nahas-Neto, C.L. Orsatti, F.N. Bueloni-Dias, E.A. Nahas, Effect of vitamin D supplementation alone on muscle function in postmenopausal women: a randomized, double-blind, placebo-controlled clinical trial. Osteoporos. Int. 26, 2413–2421 (2015)CrossRefPubMed
3.
4.
go back to reference G. Muscogiuri, V. Nuzzo, A. Gatti, A. Zuccoli, S. Savastano, C. Di Somma, R. Pivonello, F. Orio, A. Colao, Hypovitaminosis D: a novel risk factor for coronary heart disease in type 2 diabetes? Endocrine (2015). doi:10.1007/s12020-015-0609-7 G. Muscogiuri, V. Nuzzo, A. Gatti, A. Zuccoli, S. Savastano, C. Di Somma, R. Pivonello, F. Orio, A. Colao, Hypovitaminosis D: a novel risk factor for coronary heart disease in type 2 diabetes? Endocrine (2015). doi:10.​1007/​s12020-015-0609-7
5.
go back to reference T. Skaaby, L.L. Husemoen, B.H. Thuesen, A. Linneberg, Prospective population-based study of the association between vitamin D status and incidence of autoimmune disease. Endocrine 50, 231–238 (2015)CrossRefPubMed T. Skaaby, L.L. Husemoen, B.H. Thuesen, A. Linneberg, Prospective population-based study of the association between vitamin D status and incidence of autoimmune disease. Endocrine 50, 231–238 (2015)CrossRefPubMed
7.
go back to reference M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney, M.H. Murad, C.M. Weaver, Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 96, 1911–1930 (2011)CrossRefPubMed M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney, M.H. Murad, C.M. Weaver, Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 96, 1911–1930 (2011)CrossRefPubMed
8.
go back to reference C.E. Powe, C. Ricciardi, A.H. Berg, D. Erdenesanaa, G. Collerone, E. Ankers, J. Wenger, S.A. Karumanchi, R. Thadhani, I. Bhan, Vitamin D-binding protein modifies the vitamin D-bone mineral density relationship. J. Bone Miner. Res. 26, 1609–1616 (2011)CrossRefPubMedPubMedCentral C.E. Powe, C. Ricciardi, A.H. Berg, D. Erdenesanaa, G. Collerone, E. Ankers, J. Wenger, S.A. Karumanchi, R. Thadhani, I. Bhan, Vitamin D-binding protein modifies the vitamin D-bone mineral density relationship. J. Bone Miner. Res. 26, 1609–1616 (2011)CrossRefPubMedPubMedCentral
9.
go back to reference J.B. Schwartz, J. Lai, B. Lizaola, L. Kane, S. Markova, P. Weyland, N.A. Terrault, N. Stotland, D. Bikle, A comparison of measured and calculated free 25(OH) vitamin D levels in clinical populations. J. Clin. Endocrinol. Metab. 99, 1631–1637 (2014)CrossRefPubMedPubMedCentral J.B. Schwartz, J. Lai, B. Lizaola, L. Kane, S. Markova, P. Weyland, N.A. Terrault, N. Stotland, D. Bikle, A comparison of measured and calculated free 25(OH) vitamin D levels in clinical populations. J. Clin. Endocrinol. Metab. 99, 1631–1637 (2014)CrossRefPubMedPubMedCentral
10.
go back to reference J.C. Lai, D.D. Bikle, B. Lizaola, H. Hayssen, N.A. Terrault, J.B. Schwartz, Total 25(OH)vitamin D, free 25(OH) vitamin D and markers of bone turnover in cirrhotics with and without synthetic dysfunction. Liver Int. 35, 2294–2300 (2015)CrossRefPubMed J.C. Lai, D.D. Bikle, B. Lizaola, H. Hayssen, N.A. Terrault, J.B. Schwartz, Total 25(OH)vitamin D, free 25(OH) vitamin D and markers of bone turnover in cirrhotics with and without synthetic dysfunction. Liver Int. 35, 2294–2300 (2015)CrossRefPubMed
11.
go back to reference C.M. Mendel, The free hormone hypothesis: a physiologically based mathematical model. Endocr. Rev. 10, 232–274 (1989)CrossRefPubMed C.M. Mendel, The free hormone hypothesis: a physiologically based mathematical model. Endocr. Rev. 10, 232–274 (1989)CrossRefPubMed
12.
go back to reference D.D. Bikle, E. Gee, B. Halloran, M.A. Kowalski, E. Ryzen, J.G. Haddad, Assessment of the free fraction of 25-hydroxyvitamin D in serum and its regulation by albumin and the vitamin D-binding protein. J. Clin. Endocrinol. Metab. 63, 954–959 (1986)CrossRefPubMed D.D. Bikle, E. Gee, B. Halloran, M.A. Kowalski, E. Ryzen, J.G. Haddad, Assessment of the free fraction of 25-hydroxyvitamin D in serum and its regulation by albumin and the vitamin D-binding protein. J. Clin. Endocrinol. Metab. 63, 954–959 (1986)CrossRefPubMed
13.
go back to reference F.F. Safadi, P. Thornton, H. Magiera, B.W. Hollis, M. Gentile, J.G. Haddad, S.A. Liebhaber, N.E. Cooke, Osteopathy and resistance to vitamin D toxicity in mice null for vitamin D binding protein. J. Clin. Invest. 103, 239–251 (1999)CrossRefPubMedPubMedCentral F.F. Safadi, P. Thornton, H. Magiera, B.W. Hollis, M. Gentile, J.G. Haddad, S.A. Liebhaber, N.E. Cooke, Osteopathy and resistance to vitamin D toxicity in mice null for vitamin D binding protein. J. Clin. Invest. 103, 239–251 (1999)CrossRefPubMedPubMedCentral
14.
go back to reference P.L. Havens, J.J. Kiser, C.B. Stephensen, R. Hazra, P.M. Flynn, C.M. Wilson, B. Rutledge, J. Bethel, C.G. Pan, L.R. Woodhouse, M.D. Van Loan, N. Liu, J. Lujan-Zilbermann, A. Baker, B.G. Kapogiannis, C.M. Gordon, K. Mulligan, Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) 063 Study Team. Association of higher plasma vitamin D binding protein and lower free calcitriol levels with tenofovir disoproxil fumarate use and plasma and intracellular tenofovir pharmacokinetics: cause of a functional vitamin D deficiency? Antimicrob. Agents Chemother. 57, 5619–5628 (2013)CrossRefPubMedPubMedCentral P.L. Havens, J.J. Kiser, C.B. Stephensen, R. Hazra, P.M. Flynn, C.M. Wilson, B. Rutledge, J. Bethel, C.G. Pan, L.R. Woodhouse, M.D. Van Loan, N. Liu, J. Lujan-Zilbermann, A. Baker, B.G. Kapogiannis, C.M. Gordon, K. Mulligan, Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) 063 Study Team. Association of higher plasma vitamin D binding protein and lower free calcitriol levels with tenofovir disoproxil fumarate use and plasma and intracellular tenofovir pharmacokinetics: cause of a functional vitamin D deficiency? Antimicrob. Agents Chemother. 57, 5619–5628 (2013)CrossRefPubMedPubMedCentral
16.
go back to reference G. Mazziotti, E. Biagioli, F. Maffezzoni, M. Spinello, V. Serra, R. Maroldi, I. Floriani, A. Giustina, Bone turnover, bone mineral density, and fracture risk in acromegaly: a meta-analysis. J. Clin. Endocrinol. Metab. 100, 384–394 (2015)CrossRefPubMed G. Mazziotti, E. Biagioli, F. Maffezzoni, M. Spinello, V. Serra, R. Maroldi, I. Floriani, A. Giustina, Bone turnover, bone mineral density, and fracture risk in acromegaly: a meta-analysis. J. Clin. Endocrinol. Metab. 100, 384–394 (2015)CrossRefPubMed
17.
go back to reference G. Mazziotti, V. Cimino, E. De Menis, S. Bonadonna, G. Bugari, L. De Marinis, J.D. Veldhuis, A. Giustina, Active acromegaly enhances spontaneous parathyroid hormone pulsatility. Metabolism 55, 736–740 (2006)CrossRefPubMed G. Mazziotti, V. Cimino, E. De Menis, S. Bonadonna, G. Bugari, L. De Marinis, J.D. Veldhuis, A. Giustina, Active acromegaly enhances spontaneous parathyroid hormone pulsatility. Metabolism 55, 736–740 (2006)CrossRefPubMed
18.
go back to reference P. Ameri, A. Giusti, M. Boschetti, G. Murialdo, F. Minuto, D. Ferone, Interactions between vitamin D and IGF-I: from physiology to clinical practice. Clin. Endocrinol. 79, 457–463 (2013)CrossRef P. Ameri, A. Giusti, M. Boschetti, G. Murialdo, F. Minuto, D. Ferone, Interactions between vitamin D and IGF-I: from physiology to clinical practice. Clin. Endocrinol. 79, 457–463 (2013)CrossRef
19.
go back to reference J. Halupczok-Żyła, A. Jawiarczyk-Przybyłowska, M. Bolanowski, Patients with active acromegaly are at righ risk of 25(OH)D deficiency. Front Endocrinol. 6, 89 (2015) J. Halupczok-Żyła, A. Jawiarczyk-Przybyłowska, M. Bolanowski, Patients with active acromegaly are at righ risk of 25(OH)D deficiency. Front Endocrinol. 6, 89 (2015)
20.
go back to reference A.E. Altinova, C. Ozkan, M. Akturk, O. Gulbahar, M. Yalcin, N. Cakir, F.B. Toruner, Vitamin D-binding protein and free vitamin D concentrations in acromegaly. Endocrine (2015). doi:10.1007/s12020-015-0789-1 A.E. Altinova, C. Ozkan, M. Akturk, O. Gulbahar, M. Yalcin, N. Cakir, F.B. Toruner, Vitamin D-binding protein and free vitamin D concentrations in acromegaly. Endocrine (2015). doi:10.​1007/​s12020-015-0789-1
22.
go back to reference J. Arnaud, J. Constans, Affinity differences for vitamin D metabolites associated with the genetic isoforms of the human serum carrier protein (DBP). Hum. Genet. 92, 183–188 (1993)CrossRefPubMed J. Arnaud, J. Constans, Affinity differences for vitamin D metabolites associated with the genetic isoforms of the human serum carrier protein (DBP). Hum. Genet. 92, 183–188 (1993)CrossRefPubMed
23.
go back to reference Y.L. Wang, H. Kong, W.P. Xie, H. Wang, Association of vitamin D-binding protein variants with chronic obstructive pulmonary disease: a meta-analysis. Genet. Mol. Res. 14, 10774–10785 (2015)CrossRefPubMed Y.L. Wang, H. Kong, W.P. Xie, H. Wang, Association of vitamin D-binding protein variants with chronic obstructive pulmonary disease: a meta-analysis. Genet. Mol. Res. 14, 10774–10785 (2015)CrossRefPubMed
24.
go back to reference A.L. Schneider, P.L. Lutsey, E. Selvin, T.H. Mosley, A.R. Sharrett, K.A. Carson, W.S. Post, J.S. Pankow, A.R. Folsom, R.F. Gottesman, E.D. Michos, Vitamin D, vitamin D binding protein gene polymorphisms, race and risk of incident stroke: the Atherosclerosis Risk in Communities (ARIC) study. Eur. J. Neurol. 22, 1220–1227 (2015)CrossRefPubMedPubMedCentral A.L. Schneider, P.L. Lutsey, E. Selvin, T.H. Mosley, A.R. Sharrett, K.A. Carson, W.S. Post, J.S. Pankow, A.R. Folsom, R.F. Gottesman, E.D. Michos, Vitamin D, vitamin D binding protein gene polymorphisms, race and risk of incident stroke: the Atherosclerosis Risk in Communities (ARIC) study. Eur. J. Neurol. 22, 1220–1227 (2015)CrossRefPubMedPubMedCentral
25.
go back to reference A.N. Hoofnagle, J.H. Eckfeldt, P.L. Lutsey, Vitamin D-binding protein concentrations quantified by mass spectrometry. N. Engl. J. Med. 373, 1480–1482 (2015)CrossRefPubMed A.N. Hoofnagle, J.H. Eckfeldt, P.L. Lutsey, Vitamin D-binding protein concentrations quantified by mass spectrometry. N. Engl. J. Med. 373, 1480–1482 (2015)CrossRefPubMed
26.
go back to reference D.D. Bikle, E. Gee, B. Halloran, J.G. Haddad, Free 1,25-dihydroxyvitamin D levels in serum from normal subjects, pregnant subjects, and subjects with liver disease. J. Clin. Invest. 74, 1966–1971 (1984)CrossRefPubMedPubMedCentral D.D. Bikle, E. Gee, B. Halloran, J.G. Haddad, Free 1,25-dihydroxyvitamin D levels in serum from normal subjects, pregnant subjects, and subjects with liver disease. J. Clin. Invest. 74, 1966–1971 (1984)CrossRefPubMedPubMedCentral
27.
go back to reference S. Bonadonna, G. Mazziotti, M. Nuzzo, A. Bianchi, A. Fusco, L. De Marinis, A. Giustina, Increased prevalence of radiological spinal deformities in active acromegaly: a cross-sectional study in postmenopausal women. J. Bone Miner. Res. 20, 1837–1844 (2005)CrossRefPubMed S. Bonadonna, G. Mazziotti, M. Nuzzo, A. Bianchi, A. Fusco, L. De Marinis, A. Giustina, Increased prevalence of radiological spinal deformities in active acromegaly: a cross-sectional study in postmenopausal women. J. Bone Miner. Res. 20, 1837–1844 (2005)CrossRefPubMed
28.
go back to reference G. Mazziotti, A. Bianchi, S. Bonadonna, V. Cimino, I. Patelli, A. Fusco, A. Pontecorvi, L. De Marinis, A. Giustina, Prevalence of vertebral fractures in men with acromegaly. J. Clin. Endocrinol. Metab. 93, 4649–4655 (2008)CrossRefPubMed G. Mazziotti, A. Bianchi, S. Bonadonna, V. Cimino, I. Patelli, A. Fusco, A. Pontecorvi, L. De Marinis, A. Giustina, Prevalence of vertebral fractures in men with acromegaly. J. Clin. Endocrinol. Metab. 93, 4649–4655 (2008)CrossRefPubMed
29.
go back to reference S. Melmed, F.F. Casanueva, A. Klibanski, M.D. Bronstein, P. Chanson, S.W. Lamberts, C.J. Strasburger, J.A. Wass, A. Giustina, A consensus on the diagnosis and treatment of acromegaly complications. Pituitary 16, 294–302 (2013)CrossRefPubMedPubMedCentral S. Melmed, F.F. Casanueva, A. Klibanski, M.D. Bronstein, P. Chanson, S.W. Lamberts, C.J. Strasburger, J.A. Wass, A. Giustina, A consensus on the diagnosis and treatment of acromegaly complications. Pituitary 16, 294–302 (2013)CrossRefPubMedPubMedCentral
30.
go back to reference R.F. Chun, A.L. Lauridsen, L. Suon, L.A. Zella, J.W. Pike, R.L. Modlin, A.R. Martineau, R.J. Wilkinson, J. Adams, M. Hewison, Vitamin D-binding protein directs monocyte responses to 25-hydroxy- and 1,25-dihydroxyvitamin D. J. Clin. Endocrinol. Metab. 95, 3368–3376 (2010)CrossRefPubMedPubMedCentral R.F. Chun, A.L. Lauridsen, L. Suon, L.A. Zella, J.W. Pike, R.L. Modlin, A.R. Martineau, R.J. Wilkinson, J. Adams, M. Hewison, Vitamin D-binding protein directs monocyte responses to 25-hydroxy- and 1,25-dihydroxyvitamin D. J. Clin. Endocrinol. Metab. 95, 3368–3376 (2010)CrossRefPubMedPubMedCentral
31.
go back to reference G.B. Schneider, K.A. Benis, N.W. Flay, R.A. Irelan, S.N. Popoff, Effects of vitamin D binding protein-macrophage activating factor (DBP-MAF) infusion on bone resorption in two osteopetrotic mutations. Bone 16, 657–662 (1995)CrossRefPubMed G.B. Schneider, K.A. Benis, N.W. Flay, R.A. Irelan, S.N. Popoff, Effects of vitamin D binding protein-macrophage activating factor (DBP-MAF) infusion on bone resorption in two osteopetrotic mutations. Bone 16, 657–662 (1995)CrossRefPubMed
32.
go back to reference A. Giustina, M.D. Bronstein, F.F. Casanueva, P. Chanson, E. Ghigo, K.K. Ho, A. Klibanski, S. Lamberts, P. Trainer, S. Melmed, Current management practices for acromegaly: an international survey. Pituitary 14, 125–133 (2011)CrossRefPubMed A. Giustina, M.D. Bronstein, F.F. Casanueva, P. Chanson, E. Ghigo, K.K. Ho, A. Klibanski, S. Lamberts, P. Trainer, S. Melmed, Current management practices for acromegaly: an international survey. Pituitary 14, 125–133 (2011)CrossRefPubMed
33.
go back to reference A. Giustina, A. Barkan, P. Chanson, A. Grossman, A. Hoffman, E. Ghigo, F. Casanueva, A. Colao, S. Lamberts, M. Sheppard, S. Melmed, Pituitary Society; European Neuroendocrine Association: guidelines for the treatment of growth hormone excess and growth hormone deficiency in adults. J. Endocrinol. Invest. 31, 820–838 (2008)CrossRefPubMed A. Giustina, A. Barkan, P. Chanson, A. Grossman, A. Hoffman, E. Ghigo, F. Casanueva, A. Colao, S. Lamberts, M. Sheppard, S. Melmed, Pituitary Society; European Neuroendocrine Association: guidelines for the treatment of growth hormone excess and growth hormone deficiency in adults. J. Endocrinol. Invest. 31, 820–838 (2008)CrossRefPubMed
34.
go back to reference H.B. Fiebrich, G. Van Den Berg, I.P. Kema, T.P. Links, J.H. Kleibeuker, A.P. Van Beek, A.M. Walenkamp, W.J. Sluiter, E.G. De Vries, Deficiencies in fat-soluble vitamins in long-term users of somatostatin analogue. Aliment. Pharmacol. Ther. 32, 1398–1404 (2010)CrossRefPubMed H.B. Fiebrich, G. Van Den Berg, I.P. Kema, T.P. Links, J.H. Kleibeuker, A.P. Van Beek, A.M. Walenkamp, W.J. Sluiter, E.G. De Vries, Deficiencies in fat-soluble vitamins in long-term users of somatostatin analogue. Aliment. Pharmacol. Ther. 32, 1398–1404 (2010)CrossRefPubMed
35.
go back to reference A. Ajmal, A. Haghshenas, S. Attarian, M. Barake, N.A. Tritos, A. Klibanski, K.K. Miller, L.B. Nachtigall, The effect of somatostatin analogs on vitamin D and calcium concentrations in patients with acromegaly. Pituitary 17, 366–373 (2014)CrossRefPubMed A. Ajmal, A. Haghshenas, S. Attarian, M. Barake, N.A. Tritos, A. Klibanski, K.K. Miller, L.B. Nachtigall, The effect of somatostatin analogs on vitamin D and calcium concentrations in patients with acromegaly. Pituitary 17, 366–373 (2014)CrossRefPubMed
36.
go back to reference A. Giustina, G. Mazziotti, V. Torri, M. Spinello, I. Floriani, S. Melmed, Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS ONE 7, e36411 (2012)CrossRefPubMedPubMedCentral A. Giustina, G. Mazziotti, V. Torri, M. Spinello, I. Floriani, S. Melmed, Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS ONE 7, e36411 (2012)CrossRefPubMedPubMedCentral
Metadata
Title
Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy?
Authors
G. Mazziotti
F. Maffezzoni
A. Giustina
Publication date
01-05-2016
Publisher
Springer US
Published in
Endocrine / Issue 2/2016
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-016-0890-0

Other articles of this Issue 2/2016

Endocrine 2/2016 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.