衰老的心血管系统：从细胞和临床层面理解它。

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

机构信息

Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland; University Heart Center, Cardiology, University Hospital Zurich, Zurich, Switzerland.

Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.

出版信息

J Am Coll Cardiol. 2017 Apr 18;69(15):1952-1967. doi: 10.1016/j.jacc.2017.01.064.

DOI:10.1016/j.jacc.2017.01.064

PMID:28408026

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.

摘要

心血管疾病 (CVD) 给老年患者、他们的照顾者和医疗系统带来了巨大的负担。血管的结构和功能改变会在整个生命周期中累积，最终导致 CVD 风险增加。全球老年人口的增长凸显了需要了解衰老如何促进 CVD 的必要性，以便制定新的策略来应对这一挑战。本篇综述提供了在日常心血管实践中护理老年患者时遇到的一些重大未解决的临床问题的例子。接下来，作者总结了目前对心血管衰老相关机制的理解，以及靶向内皮功能障碍、线粒体氧化应激、染色质重塑和基因组不稳定性等新途径的潜力。最后，作者考虑了血管修复的关键方面，包括老年患者自体骨髓源性干细胞的移植。