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The Future of Biomarker-Guided Therapy for Heart Failure After the Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Study Transcatheter Aortic Valve Replacement During Pregnancy Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis Longitudinal Assessment of Vascular Function With Sunitinib in Patients With Metastatic Renal Cell Carcinoma Criteria for Iron Deficiency in Patients With Heart Failure Histopathologic validation of the intravascular ultrasound diagnosis of calcified coronary artery nodules Comparison of inhospital mortality, length of hospitalization, costs, and vascular complications of percutaneous coronary interventions guided by ultrasound versus angiography Comprehensive intravascular ultrasound assessment of stent area and its impact on restenosis and adverse cardiac events in 403 patients with unprotected left main disease 3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation Prior Pacemaker Implantation and Clinical Outcomes in Patients With Heart Failure and Preserved Ejection Fraction

Review ArticleVolume 74, Issue 6, 13 August 2019, Pages 804-813

JOURNAL:J Am Coll Cardiol. Article Link

Cardiovascular Aging and Heart Failure: JACC Review Topic of the Week

F Triposkiadis, A Xanthopoulos, J Butler et al. Keywords: aging; amyloidosis; comorbidities; heart failure; risk factors

ABSTRACT


Heart failure (HF) is a clinical syndrome that usually develops in the elderly. Complex interactions of the cardiovascular aging process with risk factors (obesity, hypertension, and atherosclerosis), comorbidities (anemia, chronic kidney disease, diabetes, and so on), and disease modifiers (sex, genes, others) contribute to the development of HF phenotype and outcome. A conglomerate of cellular and molecular mechanisms underlies the effects of aging on cardiovascular function, the most important being excessive oxidative stress and chronic low-grade inflammation superimposed on the limited cardiac regeneration capacity. Notably, a sizeable percentage of elderly HF patients have cardiac amyloidosis, an HF precipitator. This review summarizes the current published data on the mechanisms of cardiovascular aging as they contribute to the development of HF phenotype and outcome.