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Cardiac aging – a review

Übersicht zum kardialen Altern

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Zusammenfassung

GRUNDLAGEN: Der physiologische Vorgang des Alterns bedingt vielschichtige Veränderungen auf verschiedenen Ebenen des kardiovaskulären Systems und führt schließlich zu einem progressiven Remodeling von Herz und Kreislauf. METHODIK: Ziel dieser Übersichtsarbeit ist die Darstellung der altersbedingten zellulären und molekularen Veränderungen mit besonderem Augenmerk auf die neurohumorale Antwort, die Autophagie und die extrazelluäre Matrix. ERGEBNISSE: Altersbedinge Veränderungen kommen sowohl auf der Ebene des einzelnen Kardiomyozyten, der neurohumoralen Antwort, aber auch der extrazellulären Matrix vor. Erschwert wird dies noch zur zahlreiche Interaktionen der beteiligen Partner. Einerseits kommt es im alten Herz durch Veränderungen des adrenergen Nervensystems und des Renin-Angiotensin-Systems zu einer veränderten neurohumoralen Antwort. Andererseits kommt es durch den verminderten Abtransport von intrazellulären Abbauprodukten zu einer Vermehrung des oxidativen Stresses und dadurch zu einem Anhäufen dieser Abbauprodukte in der Zelle. Schlussendlich werden auch in der extrazellulären Matrix vermehrt diese Abbauprodukte sowie Kollagen eingelagert, was die Pumpfunktion des alten Herzens weiter verschlechtert. SCHLUSSFOLGERUNGEN: Im Zuge des Alterns kommt es auf verschiedenen Ebenen des kardiovaskulären Systems zu Modifikationen. Dieses "Remodeling" wird durch die gegenseitige Beeinflussung der einzelnen Prozesse noch verstärkt. Weitere Untersuchungen werden notwendig sein um einerseits Klarheit über Ursache und Wirkung zu erhalten, andererseits um die Hierarchie dieser Abläufe zu verstehen.

Summary

BACKGROUND: Physiology of aging includes numerous modifications at different levels of the cardiovascular system, resulting in adverse remodeling of the heart and blood vessels. METHODS: The present review aims to summarize the different mechanisms in detail during the process of aging with special emphasis on the neurohumoral regulation, autophagy, and remodeling of the extracellular matrix (ECM). RESULTS: Age-associated cellular and molecular mechanisms involve cardiomyocyte function, alterations of neurohormonal regulation, as well as changes in the ECM. Moreover, interactions between the distinct territories involved in the age-related modifications increase the complexity of senescence-associated cardiovascular remodeling. Altered adrenergic and renin-angiotensin systems control neurohormonal regulation of age-associated cardiovascular function. Increased oxidative stress induces enhanced production of cellular waste material, and facilitates the detrimental effects of aging on senescent cardiomyocytes, which are unable to maintain their homeostasis and redox equilibrium due to altered autophagic capacity. Increased collagen and advanced glycation endproducts (AGEs) deposition in the ECM further worsen global function of the aging heart. CONCLUSIONS: During the aging process, several modifications in the heart and blood vessels occur at different levels of the cardiovascular system. This adverse remodeling is further influenced by a number of cross-talk actions between the separate mechanisms. Further investigations are needed to elucidate the exact cause-effect relations among the underlying mechanisms, and to clarify their hierarchical position during the course of the aging process.

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Authors and Affiliations

  1. Medical and Health Science Center, Division of Clinical Physiology, Institute of Cardiology, University of Debrecen, Debrecen, Hungary

    D. Czuriga, Z. Papp, I. Czuriga & Á. Balogh

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  1. D. Czuriga
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  2. Z. Papp
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  3. I. Czuriga
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  4. Á. Balogh
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Correspondence to D. Czuriga.

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Czuriga, D., Papp, Z., Czuriga, I. et al. Cardiac aging – a review. Eur Surg 43, 69–77 (2011). https://doi.org/10.1007/s10353-011-0600-3

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  • DOI: https://doi.org/10.1007/s10353-011-0600-3

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