Cardiovascular aging and heart failure

The aging process is a major factor that contributes to changes seen in the cardiovascular system in older people. Stiffening of the arterial tree alters afterload and left ventricular geometry and although resting left ventricular systolic function is maintained, left ventricular diastolic function changes substantially. Cardiovascular function in older people during exercise is also significantly altered but can be modified by exercise training in older adults or genetic modification in animals. Age‐related changes in cardiovascular structure and function also lower the threshold at which cardiac diseases become apparent. This review describes the changes in cardiovascular structure and function at rest and during exercise in older people and highlights their consequences.

[1]  H. Schirmer,et al.  Mitral flow derived Doppler indices of left ventricular diastolic function in a general population; the Tromso study. , 2000, European heart journal.

[2]  D. Levy,et al.  Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. , 1999, Journal of the American College of Cardiology.

[3]  G Olivetti,et al.  Myocyte cell loss and myocyte cellular hyperplasia in the hypertrophied aging rat heart. , 1990, Circulation research.

[4]  L. Kuller,et al.  Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study. , 1995, Annals of epidemiology.

[5]  D. Levy,et al.  Determinants of Doppler indexes of left ventricular diastolic function in normal subjects (the Framingham Heart Study). , 1992, The American journal of cardiology.

[6]  J. Cleveland,et al.  Human SERCA2a levels correlate inversely with age in senescent human myocardium. , 1998, Journal of the American College of Cardiology.

[7]  Y. Okano,et al.  Relation between exercise capacity and left ventricular systolic versus diastolic function during exercise in patients after myocardial infarction , 2001, Coronary artery disease.

[8]  D. Kitzman,et al.  Evaluation of left ventricular diastolic function from the pattern of left ventricular filling , 1998, Clinical cardiology.

[9]  V. Froelicher,et al.  Exercise standards. A statement for health professionals from the American Heart Association. , 1990, Circulation.

[10]  A. Ehsani,et al.  Exercise training enhances cardiac function in response to an afterload stress in older men. , 1997, The American journal of physiology.

[11]  H. S. Klopfenstein,et al.  Left ventricular diastolic filling in the elderly: the cardiovascular health study. , 1998, The American journal of cardiology.

[12]  W. Kohrt,et al.  Differences in cardiovascular adaptations to endurance exercise training between older men and women. , 1993, Journal of applied physiology.

[13]  J. Melin,et al.  Contribution of left ventricular diastolic function to exercise capacity in normal subjects. , 1993, Journal of applied physiology.

[14]  G. E. Newman,et al.  Effect of brief and prolonged exercise on left ventricular function. , 1980, The American journal of cardiology.

[15]  J. Fleg,et al.  Role of muscle loss in the age-associated reduction in VO2 max. , 1988, Journal of applied physiology.

[16]  M. Rich,et al.  CONGESTIVE HEART FAILURE IN OLDER ADULTS * : Epidemiology, Pathophysiology, and Etiology of Congestive Heart Failure in Older Adults , 1997, Journal of the American Geriatrics Society.

[17]  G. Taffet,et al.  Exercise training improves lusitropy by isoproterenol in papillary muscles from aged rats. , 1996, Journal of applied physiology.

[18]  M. Quiñones,et al.  Quantification of atrial contribution to left ventricular filling by pulsed Doppler echocardiography and the effect of age in normal and diseased hearts. , 1987, The American journal of cardiology.

[19]  M. Joyner,et al.  Effect of exercise on arterial compliance. , 2000, Circulation.

[20]  V. Froelicher,et al.  Exercise standards. A statement for healthcare professionals from the American Heart Association. Writing Group. , 1995, Circulation.

[21]  A P Avolio,et al.  Effects of age on ventricular-vascular coupling. , 1985, The American journal of cardiology.

[22]  H. C. Kim,et al.  Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. , 1997, Journal of the American College of Cardiology.

[23]  D. Kass,et al.  Hemodynamic effects of unloading the old heart. , 1999, American journal of physiology. Heart and circulatory physiology.

[24]  N. Jones,et al.  Exercise limitation in health and disease. , 2000, The New England journal of medicine.

[25]  S. Crouse,et al.  Endurance Training, Cardiovascular Function and the Aged , 1993, Sports medicine.

[26]  T. Wakatsuki,et al.  Clinical application of pulsed Doppler tissue imaging for assessing abnormal left ventricular relaxation. , 1997, The American journal of cardiology.

[27]  A. Ehsani,et al.  β-Adrenergic-mediated improvement in left ventricular function by exercise training in older men. , 1998, American journal of physiology. Heart and circulatory physiology.

[28]  A. Ehsani,et al.  b-Adrenergic-mediated improvement in left ventricular function by exercise training in older men , 1998 .

[29]  Mario J. Garcia,et al.  Assessment of diastolic function by tissue Doppler echocardiography: comparison with standard transmitral and pulmonary venous flow. , 1999, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[30]  John O. Holloszy,et al.  Effects of Aging, Sex, and Physical Training on Cardiovascular Responses to Exercise , 1992, Circulation.

[31]  M. Harrison,et al.  Effect of heart rate on left ventricular diastolic transmitral flow velocity patterns assessed by Doppler echocardiography in normal subjects. , 1991, The American journal of cardiology.

[32]  G. Realdi,et al.  Ageing induces left ventricular concentric remodelling in normotensive subjects , 1995, Journal of hypertension.

[33]  W. Edwards,et al.  Age-related changes in normal human hearts during the first 10 decades of life. Part II (Maturity): A quantitative anatomic study of 765 specimens from subjects 20 to 99 years old. , 1988, Mayo Clinic proceedings.

[34]  J. Fleg,et al.  Effects of Age and Aerobic Capacit on Arterial Stiffness in Healthy Adults , 1993, Circulation.

[35]  E. Lakatta Do hypertension and aging have a similar effect on the myocardium? , 1987, Circulation.

[36]  K. Saupe,et al.  Exercise Training Attenuates Age-Associated Diastolic Dysfunction in Rats , 2001, Circulation.

[37]  C H Chen,et al.  Coupled systolic-ventricular and vascular stiffening with age: implications for pressure regulation and cardiac reserve in the elderly. , 1998, Journal of the American College of Cardiology.

[38]  J. Fleg,et al.  Age-associated changes in left ventricular diastolic performance during isometric exercise in normal subjects. , 1992, The American journal of cardiology.

[39]  M. Winker,et al.  Age and the cardiovascular system. , 1993, The New England journal of medicine.

[40]  E. Lakatta,et al.  Cardiovascular aging in health. , 2000, Clinics in geriatric medicine.

[41]  T. Nakano,et al.  Effects of aging on left ventricular relaxation in humans. Analysis of left ventricular isovolumic pressure decay. , 1997, Circulation.

[42]  C. G. Blomqvist,et al.  A 30-Year Follow-Up of the Dallas Bed Rest and Training Study: II. Effect of Age on Cardiovascular Adaptation to Exercise Training , 2001, Circulation.

[43]  D. Brutsaert,et al.  Nonuniformity: a physiologic modulator of contraction and relaxation of the normal heart. , 1987, Journal of the American College of Cardiology.

[44]  G. Taffet,et al.  Mechanisms for the responses of cardiac muscle to physical activity in old age. , 1994, Medicine and science in sports and exercise.

[45]  A J Tajik,et al.  Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone. , 1997, Journal of the American College of Cardiology.

[46]  J H Wilmore,et al.  Twenty-year follow-up of aerobic power and body composition of older track athletes. , 1997, Journal of applied physiology.

[47]  A. Young,et al.  The physiology of physical performance and training in old age. , 1999, Coronary artery disease.

[48]  G. Taffet,et al.  Enhanced calcium uptake of cardiac sarcoplasmic reticulum in exercise-trained old rats. , 1990, The American journal of physiology.

[49]  J. Morley,et al.  Clinical implications of the aging heart. , 1989, The American journal of medicine.

[50]  G Olivetti,et al.  Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy. , 1991, Circulation research.

[51]  J. Fleg,et al.  Age-associated changes in left ventricular outflow tract geometry in normal subjects. , 1996, The American journal of cardiology.

[52]  Mario J. Garcia,et al.  New Doppler echocardiographic applications for the study of diastolic function. , 1998, Journal of the American College of Cardiology.

[53]  R H Jones,et al.  Effect of age on the response of the left ventricular ejection fraction to exercise. , 1980, The New England journal of medicine.

[54]  U. Schmidt,et al.  Restoration of diastolic function in senescent rat hearts through adenoviral gene transfer of sarcoplasmic reticulum Ca(2+)-ATPase. , 2000, Circulation.

[55]  D. Kitzman,et al.  Age-related alterations of Doppler left ventricular filling indexes in normal subjects are independent of left ventricular mass, heart rate, contractility and loading conditions. , 1991, Journal of the American College of Cardiology.

[56]  A. Labovitz,et al.  Echocardiographic evaluation of cardiac structure and function in elderly subjects with isolated systolic hypertension. , 1991, Journal of the American College of Cardiology.

[57]  V. Froelicher,et al.  Exercise standards. A statement for healthcare professionals from the American Heart Association. Writing Group. , 1995, Circulation.

[58]  M. Cerqueira,et al.  Beta-adrenergic effects on left ventricular filling: influence of aging and exercise training. , 1994, Journal of applied physiology.

[59]  J. Libonati Myocardial diastolic function and exercise. , 1999, Medicine and science in sports and exercise.

[60]  B. Wandt,et al.  Left ventricular contraction pattern changes with age in normal adults. , 1998, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[61]  J. Fleg,et al.  Exercise cardiac output is maintained with advancing age in healthy human subjects: cardiac dilatation and increased stroke volume compensate for a diminished heart rate. , 1984, Circulation.

[62]  M. Cerqueira,et al.  Cardiovascular responses to exercise. Effects of aging and exercise training in healthy men. , 1994, Circulation.

[63]  D. Levy,et al.  Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). , 1989, The American journal of cardiology.

[64]  J. Thomas,et al.  Assessment of mitral annular dynamics during diastole by Doppler tissue imaging: comparison with mitral Doppler inflow in subjects without heart disease and in patients with left ventricular hypertrophy. , 1996, American heart journal.

[65]  D. Levy,et al.  Reference values for Doppler indexes of left ventricular diastolic filling in the elderly. , 1993, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[66]  J. Gardin,et al.  Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. , 1994, American journal of epidemiology.

[67]  N. Ohte,et al.  Evaluation of left ventricular early diastolic performance by color tissue Doppler imaging of the mitral annulus. , 1998, The American journal of cardiology.

[68]  W. Little,et al.  Mechanism of altered pattern of left ventricular filling with aging in subjects without cardiac disease. , 1989, The American journal of cardiology.

[69]  E. Lakatta,et al.  Cardiovascular regulatory mechanisms in advanced age. , 1993, Physiological reviews.

[70]  M. Cerqueira,et al.  Endurance Exercise Training Augments Diastolic Filling at Rest and During Exercise in Healthy Young and Older Men , 1993, Circulation.