Aging and cardiac fibrosis

Research output: Contribution to journalArticle

205 Citations (Scopus)

Abstract

The aging heart is characterized by morphological and structural changes that lead to its functional decline and are associated with diminished ability to meet increased demand. Extensive evidence, derived from both clinical and experimental studies suggests that the aging heart undergoes fibrotic remodeling. Age-dependent accumulation of collagen in the heart leads to progressive increase in ventricular stiffness and impaired diastolic function. Increased mechanical load, due to reduced arterial compliance, and direct senescence-associated fibrogenic actions appear to be implicated in the pathogenesis of cardiac fibrosis in the elderly. Evolving evidence suggests that activation of several distinct molecular pathways may contribute to age-related fibrotic cardiac remodeling. Reactive oxygen species, chemokine-mediated recruitment of mononuclear cells and fibroblast progenitors, transforming growth factor (TGF)-β activation, endothelin-1 and angiotensin II signaling mediate interstitial and perivascular fibrosis in the senescent heart. Reduced collagen degradation may be more important than increased de novo synthesis in the pathogenesis of aging-associated fibrosis. In contrast to the baseline activation of fibrogenic pathways in the senescent heart, aging is associated with an impaired reparative response to cardiac injury and defective activation of reparative fibroblasts in response to growth factors. Because these reparative defects result in defective scar formation, senescent hearts are prone to adverse dilative remodeling following myocardial infarction. Understanding the pathogenesis of interstitial fibrosis in the aging heart and dissecting the mechanisms responsible for age-associated healing defects following cardiac injury are critical in order to design new strategies for prevention of adverse remodeling and heart failure in elderly patients.

Original languageEnglish (US)
Pages (from-to)158-173
Number of pages16
JournalAging and Disease
Volume2
Issue number2
StatePublished - 2011

Fingerprint

Fibrosis
Collagen
Fibroblasts
Wounds and Injuries
Transforming Growth Factors
Endothelin-1
Chemokines
Angiotensin II
Compliance
Cicatrix
Reactive Oxygen Species
Intercellular Signaling Peptides and Proteins
Stem Cells
Heart Failure
Myocardial Infarction

Keywords

  • Aging
  • angiotensin II
  • Cardiac fibrosis
  • Cardiac remodeling
  • Chemokine
  • MCP-1
  • TGF-β

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cell Biology
  • Clinical Neurology
  • Pathology and Forensic Medicine

Cite this

Aging and cardiac fibrosis. / Biernacka, Anna; Frangogiannis, Nikolaos G.

In: Aging and Disease, Vol. 2, No. 2, 2011, p. 158-173.

Research output: Contribution to journalArticle

Biernacka, A & Frangogiannis, NG 2011, 'Aging and cardiac fibrosis', Aging and Disease, vol. 2, no. 2, pp. 158-173.
Biernacka, Anna ; Frangogiannis, Nikolaos G. / Aging and cardiac fibrosis. In: Aging and Disease. 2011 ; Vol. 2, No. 2. pp. 158-173.
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