Molecular mechanisms of cardiac myocardial remodeling during aging. Role of apoptosis
Studies on myocardial senescence are far from being academic for several reasons, Epidemiological studies have shown that diseases of the heart are one of the major causes of mortality among overall population and the main cause of death in people after 65 years of age (1). Therefore, it is of major importance to determine the physiological structure and function of the heart in healthy aged persons and to assess the limits of normality in all age groups. The clinical problem is far from being simple because obviously the basic process of senescence is intimately associated with an increased incidence of arterial hypertension, atheroclerosis, cancer, and also with several modifications in physical activity and nutritional status which all may seriously modify the myocardial structure. It is possible to carefully select aged people who have normal blood pressure and no clinical history of coronary disease, but anatomical studies have demonstrated the high incidence of occult coronary stenosis in people who die from all causes (2). Therefore, it would be very difficult to eliminate such a disease only on the basis of clinical criteria. It is also ethically difficult to organize a large epidemiological study on aging which would include routine coronarography (reviewed in 2–5). The advent of non invasive imaging techniques such as electron-beam computed tomography (6) may prove to be of value in this setting. From a pure economical point of view, it is quite important to know whether aged myocardium behaves like myocardium of adult persons in their responses to various stimuli and drugs, and whether it would be more suitable to perform the first screening of new therapies in senescent animal models.
KeywordsHeart Rate Variability Cardiac Hypertrophy Papillary Muscle Atrial Natriuretic Factor Mechanical Overload
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