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心脏的年龄相关变化:对COVID-19治疗的影响。

Age-associated changes in the heart: implications for COVID-19 therapies.

作者信息

Wood Colby, Salter Wm Zachary, Garcia Isaiah, Nguyen Michelle, Rios Andres, Oropeza Jacqui, Ugwa Destiny, Mukherjee Upasana, Sehar Ujala, Reddy P Hemachandra

机构信息

Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.

Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX 79409, USA.

出版信息

Aging (Albany NY). 2025 May 13;17(5):1340-1367. doi: 10.18632/aging.206251.


DOI:10.18632/aging.206251
PMID:40372276
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12151517/
Abstract

Cardiac aging involves progressive structural, functional, cellular, and molecular changes that impair heart function. This review explores key mechanisms, including oxidative stress, mitochondrial dysfunction, impaired autophagy, and chronic low-grade inflammation. Excess reactive oxygen species (ROS) damage heart muscle cells, contributing to fibrosis and cellular aging. Mitochondrial dysfunction reduces energy production and increases oxidative stress, accelerating cardiac decline. Impaired autophagy limits the removal of damaged proteins and organelles, while inflammation activates signaling molecules that drive tissue remodeling. Gender differences reveal estrogen's protective role in premenopausal women, with men showing greater susceptibility to heart muscle dysfunction and injury. After menopause, women lose this hormonal protection, increasing their risk of cardiovascular conditions. Ethnic disparities, particularly among underserved minority populations, emphasize how social factors such as access to care, environment, and chronic stress contribute to worsening cardiovascular outcomes. The coronavirus disease pandemic has introduced further challenges by increasing the incidence of heart damage through inflammation, blood clots, and long-term heart failure, especially in older adults with existing metabolic conditions like diabetes and high blood pressure. The virus's interaction with receptors on heart and blood vessel cells, along with a weakened immune response in older adults, intensifies cardiac aging. Emerging therapies include delivery of therapeutic extracellular vesicles, immune cell modulation, and treatments targeting mitochondria. In addition, lifestyle strategies such as regular physical activity, nutritional improvements, and stress reduction remain vital to maintaining cardiac health. Understanding how these biological and social factors intersect is critical to developing targeted strategies that promote healthy aging of the heart.

摘要

心脏衰老涉及渐进性的结构、功能、细胞和分子变化,这些变化会损害心脏功能。本综述探讨了关键机制,包括氧化应激、线粒体功能障碍、自噬受损和慢性低度炎症。过量的活性氧(ROS)会损害心肌细胞,导致纤维化和细胞衰老。线粒体功能障碍会减少能量产生并增加氧化应激,加速心脏功能衰退。自噬受损会限制受损蛋白质和细胞器的清除,而炎症会激活驱动组织重塑的信号分子。性别差异显示雌激素在绝经前女性中具有保护作用,男性对心肌功能障碍和损伤更敏感。绝经后,女性失去这种激素保护,心血管疾病风险增加。种族差异,特别是在服务不足的少数族裔人群中,凸显了获得医疗保健、环境和慢性压力等社会因素如何导致心血管疾病恶化。冠状病毒病大流行通过炎症、血栓和长期心力衰竭增加心脏损伤的发生率,给心脏衰老带来了进一步挑战,尤其是在患有糖尿病和高血压等现有代谢疾病的老年人中。病毒与心脏和血管细胞上的受体相互作用,以及老年人免疫反应减弱,加剧了心脏衰老。新兴疗法包括递送治疗性细胞外囊泡、免疫细胞调节和针对线粒体的治疗。此外,定期体育锻炼、改善营养和减轻压力等生活方式策略对维持心脏健康仍然至关重要。了解这些生物和社会因素如何相互作用对于制定促进心脏健康衰老的针对性策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/033daed32a81/aging-17-206251-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/f32a0dbd161b/aging-17-206251-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/54fdc9189baa/aging-17-206251-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/e3536609b9e4/aging-17-206251-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/15da319d2c22/aging-17-206251-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/0beaeb386489/aging-17-206251-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/033daed32a81/aging-17-206251-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/f32a0dbd161b/aging-17-206251-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/54fdc9189baa/aging-17-206251-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/e3536609b9e4/aging-17-206251-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/15da319d2c22/aging-17-206251-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/0beaeb386489/aging-17-206251-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad5/12151517/033daed32a81/aging-17-206251-g006.jpg

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[1]
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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Systemic aging fuels heart failure: Molecular mechanisms and therapeutic avenues.

ESC Heart Fail. 2025-4

[2]
Socioeconomic status as a potential mediator of arterial aging in marginalized ethnic and racial groups: current understandings and future directions.

J Appl Physiol (1985). 2024-7-1

[3]
Gender disparities, causes and predictors of immediate and short-term cardiovascular readmissions following COVID-19-related hospitalisations in the USA.

BMJ Open. 2023-11-10

[4]
COVID-19 Complications: Oxidative Stress, Inflammation, and Mitochondrial and Endothelial Dysfunction.

Int J Mol Sci. 2023-10-4

[5]
The Eye of the Storm: Investigating the Long-Term Cardiovascular Effects of COVID-19 and Variants.

Cells. 2023-8-27

[6]
COVID-19: An opportunity to engage African Americans and women in research on cardiovascular disease.

J Natl Med Assoc. 2023-10

[7]
Association between COVID-19 and incidence of cardiovascular disease and all-cause mortality among patients with diabetes.

Front Endocrinol (Lausanne). 2023

[8]
Sex-specific differences in myocardial injury incidence after COVID-19 mRNA-1273 booster vaccination.

Eur J Heart Fail. 2023-10

[9]
Risk of Cardiovascular Disease After COVID-19 Diagnosis Among Adults With and Without Diabetes.

J Am Heart Assoc. 2023-7-4

[10]
Association of Hypertension, Diabetes, and Cardiovascular Disease with COVID-19 in Africa: Scoping Review Protocol.

Trop Med Infect Dis. 2023-5-26

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