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Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population Cardiac Sympathetic Denervation for Refractory Ventricular Arrhythmias Patterns of use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers among patients with acute myocardial infarction in China from 2001 to 2011: China PEACE-Retrospective AMI Study Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial Coronary Artery Plaque Characteristics Associated With Adverse Outcomes in the SCOT-HEART Study Treatment effects of systematic two-stent and provisional stenting techniques in patients with complex coronary bifurcation lesions: rationale and design of a prospective, randomised and multicentre DEFINITION II trial Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study BMI, Infarct Size, and Clinical Outcomes Following Primary PCI Patient-Level Analysis From 6 Randomized Trials Long-Term Incremental Prognostic Value of Cardiovascular Magnetic Resonance After ST-Segment Elevation Myocardial Infarction A Study of the Collaborative Registry on CMR in STEMI Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial

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.