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INTERMACS Profiles and Outcomes Among Non–Inotrope-Dependent Outpatients With Heart Failure and Reduced Ejection Fraction The effect of complete percutaneous revascularisation with and without intravascular ultrasound guidance in the drugeluting stent era Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial Impact of Lesion Preparation Strategies on Outcomes of Left Main PCI: The EXCEL Trial A new strategy for discontinuation of dual antiplatelet therapy: the RESET Trial (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation) Dual-antiplatelet treatment beyond 1 year after drug-eluting stent implantation (ARCTIC-Interruption): a randomised trial A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis Economic and Quality-of-Life Outcomes of Natriuretic Peptide–Guided Therapy for Heart Failure Sex differences in left main coronary artery stenting: Different characteristics but similar outcomes for women compared with men The Year in Cardiovascular Medicine 2020: Valvular Heart Disease: Discussing the Year in Cardiovascular Medicine for 2020 in the field of valvular heart disease is Professor Helmut Baumgartner and Dr Javier Bermejo. Mark Nicholls reports

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.