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Heart Failure With Mid-Range (Borderline) Ejection Fraction: Clinical Implications and Future Directions Impact of intravascular ultrasound on the long-term clinical outcomes in the treatment of coronary ostial lesions Sex Differences in Heart Failure With Preserved Ejection Fraction Pathophysiology: A Detailed Invasive Hemodynamic and Echocardiographic Analysis Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology Plasma Ionized Calcium and Risk of Cardiovascular Disease: 106 774 Individuals from the Copenhagen General Population Study Novel predictor of target vessel revascularization after coronary stent implantation: Intraluminal intensity of blood speckle on intravascular ultrasound IVUS in bifurcation stenting: what have we learned? Initial Invasive or Conservative Strategy for Stable Coronary Disease Cardio-Oncology: Vascular and Metabolic Perspectives: A Scientific Statement From the American Heart Association

Clinical Trial2017 Apr 18;69(15):1952-1967.

JOURNAL:J Am Coll Cardiol. Article Link

The Aging Cardiovascular System: Understanding It at the Cellular and Clinical Levels

Paneni F, Diaz Cañestro C, Camici GG et al. Keywords: arterial stiffness; endothelium; epigenetics; stem cells

ABSTRACT


Cardiovascular disease (CVD) presents a great burden for elderly patients, their caregivers, and health systems. Structural and functional alterations of vessels accumulate throughout life, culminating in increased risk of developing CVD. The growing elderly population worldwide highlights the need to understand how aging promotes CVD in order to develop new strategies to confront this challenge. This review provides examples of some major unresolved clinical problems encountered in daily cardiovascular practice as we care for elderly patients. Next, the authors summarize the current understanding of the mechanisms implicated in cardiovascular aging, and the potential for targeting novel pathways implicated in endothelial dysfunction, mitochondrial oxidative stress, chromatin remodeling, and genomic instability. Lastly, the authors consider critical aspects of vascular repair, including autologous transplantation of bone marrow-derived stem cells in elderly patients.