2012, Number 4
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Rev Fac Med UNAM 2012; 55 (4)
The heart of the elderly
Guadalajara BJF
Language: Spanish
References: 27
Page: 30-40
PDF size: 559.56 Kb.
ABSTRACT
The heart is an hydraulic pump whose function is to provide oxygenated blood to all tissues, and to send unsaturated blood back to the lungs to maintain life; is an organ which pumps tireless since before birth; it is estimated that a 75 year old man heart has had more than 550 million beats in his lifetime.
Traditionally the heart was considered as formed by differentiated cells, which means that en old age, the heart has the same myocells it had at birth, but recent investigations confirm that heart is a dynamic organ, and between the years 20 an 100, its cell compartment has been replaced from 10 to 15 times.
Today the heart physiology and pathophysiology of the myocardial cells is better understood, as well as the role of the final portions of chromosomes, named telomers, which shorten its terminal ends as they replicate; nevertheless, they are able to restore its function through the enzyme transcriptase reverse telomerase; when the telomers reduce its length to a critical point, this loss of function induce endothelial dysfunction; the shortening of the telomers length is directly related to the heart senescence.
Several chronic diseases affect the heart: high blood pressure, diabetes mellitus, atherosclerosis, etc., therefore it is important to detect them early and to treat them accordingly, for a secondary prevention may avoid further disorders.
REFERENCES
Guadalajara JF. Cardiología, Méndez Editores, 7ª Ed. 2012, México, DF.
Portello ER, Olson EN. Building a new heart from old parts. Stem cell Turnover in the aging heart. Circ Res. 2010;107: 1292-4.
Amversa P, Kajstura J. Leri A. y col. Life and death of cardiac stem cells: A paradig shift in cardiac biology. Circulation. 2006;113:1451-63.
Poss KD, Wilson LG, Keating MT. Heart regeneration in zebrafish. Science. 2002;298:2188-21.
Hsieh PC, Seguers VF, Davis ME, et al. Evidence from a genetic fate-mapping study that stem cells refresh adult mammalian cardiomyocytes after injuri. Nat Med. 2007;13:970-4.
Quaini F, Urbanek K, Beltami AP, et al. Chimerism of the transplanted heart. N Engl J Med. 2002;346:5-15.
Woldspink DF, Burmiston JG, Tan LB. Cardiomyocyte death and the egeing and failing heart. Exp Phisiol. 2003; 88:447-58.
Kajtura J, Naracimman G, Ogorek B, et al. Myocyte turnover in the aging Human Heart. Cir Res. 2010;107:1374-86.
Urbanek K, Torella D, Sheikh F, et al. Myocardial regeneration by activation of multipotent cardiac stem cells in ischemic heart failure. Proc Natl Acad Sci USA. 2005;102:8692-7.
Atsuhiko T, Naito IS, Issei K. Wnt signaling and aging-related heart disorders. Circ Res. 2010;107:1295-303.
Oh H, Taffet GE, Youker KA, Entman ML, Overbeek PA, Michael LH, et al. Telomerase reverse transcriptase promotes cardiac muscle cell proliferation, hypertrophy, and survival. Proc Natl Acad Sci USA. 2001;98:10308-13.
Young AT, Lakey JR, Murray AG, Mullen JC, Moore RB. In vitro senescence occurring in normal human endothelial cells can be rescued by ectopic telomerase activity. Transplant Proc. 2003;35:2483-5.
Steinert S, Shay JW, Wright WE. Transient expression of human telomerase extends the life span of normal human fibroblasts. Biochem Biophys Res Commun- 2000;273:1095-8.
Lakatta EG, Levi D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprices: part I Aging arteries: A “set up” for vascular disease. Circulation. 2003; 107:139-46.
Kannel WB, Napthalie B, Skinner JJ, et al. The relation of adiposity to blood pressure and development of hypertension. The Framingham Study. Ann Int Med. 1967;67:48-59.
Sutton-Tyrrel K., Newman A., Simonsik EM. y col. Aortic stiffness is associated with visceral adiposity in older adults enrolled in the study of health aging, and body composition. Hypertension. 2001;38:429-33.
Sesso HD, Stampfer MJ, Rosner B, et al. Systolic and diastolic pressure, pulse pressure and mean arterial pressure as predictor of cardiovascular disease risk in men. Hypertension. 2000;36:801-7.
Malek AM, Alper SL, Izumo S, et al. Hemodymanic shear stress and it role in atherosclerosis. JAMA. 1999;282:2035-42.
Schramm T, Gislason GH, Lover L, et al. Diabetes patients requiring glucose-lowering therapy and non diabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 millions the people. Circulation. 2008;117:1945-54.
Rosas PM. La hipertension en México y su relación con otros factores de riesgo. Arch Cardiol Mex. 2003;73(Supl.- I):S137-S140.
Cai H, Harrison DG. Endothelial dysfunction in cardiovascular disease. N Engl J Med. 1997;336:1066-71.
Libby P. Molecular basses of acute coronary syndromes. Circulation 1995;91:2744-825.
Libby P, Therome P. Pathophysiology of coronary artery disease. Circulation. 2005;111:3481-8.
Woo KS, Chook P, Ratikari OT, et al. Westernization of Chinese adults and increased subclinical atherosclerosis. Arterioscler Thomb vasc biol. 1999;19:2487-93.
Adams MR, Nakagomi A, Keech A, et al. Carotid intimamedia thickness is only weakly correlated with the extent an severity of coronary artery disease. Circulation. 1995;92: 2127-34.
Chambless LE, Folson AR, Clegg LX, et al. Carotid wall thickness as a risk factor for myocardial infarction and stroke in older adults”. Cardiovascular health study collaborative research group. N Eng J Med. 1999;340:14-22.
Beckman JA, Creaguer MA, Libby P. Diabetes and atherosclerosis: epidemiology pathophysiology and management. JAMA 2002;287:2570-81.