Mechanisms Involved in Premature Aging in the Heart—Is There an Implication for Cardiac Surgery?

Bernd Niemann; Andreas Simm; Susanne Rohrbach

doi:10.1055/s-0037-1607052

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2018; 66(01): 031-041
DOI: 10.1055/s-0037-1607052

Review Article

Georg Thieme Verlag KG Stuttgart · New York

Mechanisms Involved in Premature Aging in the Heart—Is There an Implication for Cardiac Surgery?

Bernd Niemann

¹Department of Adult and Pediatric Cardiac and Vascular Surgery, Justus-Liebig-University Giessen, University Hospital Giessen and Marburg (UKGM), Giessen, Germany

,

Andreas Simm

²Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany

,

Susanne Rohrbach

³Institute for Physiology, Justus-Liebig-University Giessen, Giessen, Germany

› Author Affiliations

Abstract

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Abstract

During the past century, life expectancy has risen in Germany from 35.6 and 38.5 years in men and women (1871/1881) to 78.2 and 83.1 years (2013/2015). In recent years, the dominance of chronic diseases as major contributors to total global mortality has emerged. The incidence of cardiovascular diseases (CVD) increases in westernized societies and projected trends suggest that by 2030, CVD alone will also be responsible for more deaths in low-income countries than infectious diseases. The occurrence of CVD also seems to correlate to a further increase of biological age within westernized societies. Therefore, age-associated changes in the heart are an issue of high interest in cardiac surgery. The chronological age is a prognostic marker in some clinical scoring systems. However, it does not represent an adequate estimation of the biological age of patients or their perioperative risk. In fact, frailty might be a more powerful predictor for normal perioperative course or risk escalation. An unhealthy, sedentary lifestyle can induce premature aging of vessels and myocardium. Understanding the age-associated genetic, biochemical, and pathophysiological changes can help identify the therapeutic capability of aged myocardium. Future “therapeutic myocardial rejuvenation” may represent a powerful tool for the stabilization of the perioperative course in aged patients. In this review, we will focus on selected mediators or conditions with impact on age-associated myocardial changes with a major focus on obesity and discuss potential therapeutic strategies to utilize or modify these mediators.

Keywords

cardiac aging - metabolism - mitochondria - obesity - adipokines - age

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References

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