Xiao Fei, Qi Jia, Ma Shanshan, Sun Lei, Sun Yongchen
From the Department of Cardiology, Zi-Bo Central Hospital, Zibo, China.
Department of Geriatrics, Zi-Bo Central Hospital, Zibo, China.
Cardiol Rev. 2025 Apr 1. doi: 10.1097/CRD.0000000000000911.
Heart failure is closely related to aging. Elderly patients with heart failure are often able to retain normal systolic function, manifested by left ventricular hypertrophy with decreased diastolic function. Relevant studies have shown that age-related cardiac fibrosis plays an important role in the pathogenesis of cardiac diastolic heart failure. Activation of fibroblasts in the heart, the acquisition of a pro-fibrotic phenotype, and age-dependent accumulation of collagen can lead to progressive increases in myocardial stiffness and impaired diastolic function. The renin-angiotensin-aldosterone system, reactive oxygen species, and angiotensin II are closely related to fibrotic remodeling of the heart in the elderly, and their pro-fibrotic effects may be mainly mediated by transforming growth factor β. In this review, we summarize the research progress of the role and mechanism of cardiac fibrosis in the structural and functional changes of the elderly.
心力衰竭与衰老密切相关。老年心力衰竭患者通常能够保持正常的收缩功能，表现为左心室肥厚伴舒张功能下降。相关研究表明，与年龄相关的心脏纤维化在心脏舒张性心力衰竭的发病机制中起重要作用。心脏成纤维细胞的激活、促纤维化表型的获得以及胶原蛋白随年龄的积累可导致心肌僵硬度逐渐增加和舒张功能受损。肾素-血管紧张素-醛固酮系统、活性氧和血管紧张素II与老年人心脏的纤维化重塑密切相关，它们的促纤维化作用可能主要由转化生长因子β介导。在这篇综述中，我们总结了心脏纤维化在老年人结构和功能变化中的作用及机制的研究进展。
