Gao Michael, Finkel Toren
Aging Institute, University of Pittsburgh School of Medicine, 100 Technology Drive Bridgeside Point 1; Room 555, Pittsburgh, PA, 15219, USA.
Curr Cardiol Rep. 2025 Aug 15;27(1):128. doi: 10.1007/s11886-025-02279-8.
PURPOSE OF REVIEW: Metabolic changes can play a critical role in the structural and functional decline of the aging cardiovascular system. In this review, we examine how key metabolic pathways and regulatory mechanisms influence cardiovascular aging, highlighting recent studies into metabolic flexibility, mitochondrial function, nutrient sensing, and energy utilization in the aging heart. Potential metabolic-based interventions to mitigate cardiac aging are also discussed. RECENT FINDINGS: Various metabolic changes have been observed in the aging heart. Impaired metabolic flexibility, as seen by reduced fatty acid oxidation with an increased reliance on glucose, is observed. Mitochondrial dysfunction and increased oxidative stress in aged cardiomyocytes may lead to energy deficits, contributing to myocardial fibrosis and diastolic dysfunction. Accelerated cardiovascular aging is also connected to the dysregulation of nutrient-sensing pathways- such as AMP-activated protein kinase (AMPK), sirtuins, and the mechanistic target of rapamycin (mTOR). Enhancing the age-dependent decline in autophagy and mitophagy, which clears damaged organelles, appears to preserve cardiac function in aging. Recent studies have shown that interventions such as caloric restriction, exercise, and metformin can favorably remodel cardiac metabolism and delay age-related cardiac deterioration. Metabolic changes, including energy substrate shifts, mitochondrial oxidative stress, and impaired nutrient signaling, play a direct role in cardiovascular aging. Targeting these metabolic factors and pathways holds promise for alleviating age-associated cardiac dysfunction. Recent studies focusing on lifestyle or pharmacologic means of metabolic modulation provide and outline for the promotion of healthy cardiovascular aging, thereby reducing the burden of cardiovascular disease in the growing aging population.
综述目的:代谢变化在衰老心血管系统的结构和功能衰退中可能起关键作用。在本综述中,我们研究关键代谢途径和调节机制如何影响心血管衰老,重点介绍近期关于衰老心脏中代谢灵活性、线粒体功能、营养感应和能量利用的研究。还讨论了减轻心脏衰老的潜在基于代谢的干预措施。 最新发现:在衰老心脏中观察到了各种代谢变化。观察到代谢灵活性受损,表现为脂肪酸氧化减少,对葡萄糖的依赖性增加。老年心肌细胞中的线粒体功能障碍和氧化应激增加可能导致能量不足,促成心肌纤维化和舒张功能障碍。心血管衰老加速还与营养感应途径的失调有关,如AMP激活的蛋白激酶(AMPK)、沉默调节蛋白和雷帕霉素靶蛋白(mTOR)。自噬和线粒体自噬(清除受损细胞器)的年龄依赖性下降加速,而增强自噬和线粒体自噬似乎可在衰老过程中维持心脏功能。最近的研究表明,热量限制、运动和二甲双胍等干预措施可有利地重塑心脏代谢并延缓与年龄相关的心脏衰退。代谢变化,包括能量底物转变、线粒体氧化应激和营养信号受损,在心血管衰老中起直接作用。针对这些代谢因素和途径有望减轻与年龄相关的心脏功能障碍。最近关注代谢调节的生活方式或药物手段的研究为促进健康的心血管衰老提供了概述,从而减轻日益增长的老年人群中心血管疾病的负担。
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