The Aging Heart: A Molecular and Clinical Challenge

Abstract

Aging is associated with an increasing burden of morbidity, especially for cardiovascular diseases (CVDs). General cardiovascular risk factors, ischemic heart diseases, heart failure, arrhythmias, and cardiomyopathies present a significant prevalence in older people, and are characterized by peculiar clinical manifestations that have distinct features compared with the same conditions in a younger population. Remarkably, the aging heart phenotype in both healthy individuals and patients with CVD reflects modifications at the cellular level. An improvement in the knowledge of the physiological and pathological molecular mechanisms underlying cardiac aging could improve clinical management of older patients and offer new therapeutic targets.

Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

“…The aging process also relates to various alterations in the heart that predispose an individual to HF [ 65 ]. These include elastin fiber degradation, increased collagen quantity, cardiomyocyte loss and hypertrophy, and endothelial dysfunction with diminished capacity to produce NO and other vital peptides.…”

Cocoa flavanols improve peakVO2and exercise capacity in a randomized double blinded clinical trial in healthy elderly

“…Cardiac afterload is amongst others determined by blood pressure and endothelial function, alterations of both have been associated with the cardiovascular aging process (15,23). The aging heart itself is less well understood, but comprises a gradual deterioration of functional and structural characteristics including increased mass-to-volume-ratio and a decline in diastolic function (3,28). Reduced ß-adrenergic response and consecutively reduced maximum heart rate are prevalent in aging hearts (29).…”

Cocoa flavanols improve peakVO2 and exercise capacity in a randomized double blinded clinical trial in healthy elderly people

“…25,37 The aging heart itself is less well understood but comprises a gradual deterioration of functional and structural characteristics including increased mass-to-volumeratio and a decline in diastolic function. 3,42 Reduced β-adrenergic response and consecutively reduced maximum heart rate are prevalent in aging hearts. 43 Especially, agerelated decline in cardiac functional parameters can be positively modified 44,45 with aerobic interval training, while the effect of dietary interventions with CFs on exercise capacity in the elderly healthy population has not been well characterized.…”