Heart failure with preserved ejection fraction: molecular pathways of the aging myocardium.
Heart failure with preserved ejection fraction: molecular pathways of the aging myocardium.
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DOI：
10.1161/circresaha.115.302929
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发表时间：
2014-06-20
影响因子：
20.1
通讯作者：
Lee RT
中科院分区：
文献类型：
--
作者：
Loffredo FS;Nikolova AP;Pancoast JR;Lee RT
年龄相关的舒张期功能障碍是心力衰竭流行的主要因素。在因心力衰竭住院的患者中，舒张性心力衰竭现在和收缩性心力衰竭一样常见。我们现在已经有许多成功的治疗HFrEF的方法，而对于HFpEF患者的特定治疗选择仍然难以捉摸。缺乏对HFpEF的治疗反映了我们对这一系列疾病的非常不完整的理解。HFpEF的病理生理因素很多，但衰老似乎起着重要的作用。我们认为，心肌衰老本身就是一个特殊的病理生理过程。对老化心脏的新见解，包括激素控制和特定的分子途径，如microRNAs，指出心肌老化是一个潜在的可逆过程。虽然衰老的整个过程仍然是个谜，但了解心肌衰老的分子途径从未像现在这样重要。解开这些通路可能会为HFpEF的巨大和日益严重的问题带来新的治疗方法。
Age-related diastolic dysfunction is a major factor in the epidemic of heart failure. In patients hospitalized with heart failure, diastolic heart failure is now as common as systolic heart failure. We now have many successful treatments for HFrEF, while specific treatment options for HFpEF patients remain elusive. The lack of treatments for HFpEF reflects our very incomplete understanding of this constellation of diseases. There are many pathophysiological factors in HFpEF, but aging appears to play an important role. Here we propose that aging of the myocardium is itself a specific pathophysiological process. New insights into the aging heart, including hormonal controls and specific molecular pathways such as microRNAs, are pointing to myocardial aging as a potentially reversible process. While the overall process of aging remains mysterious, understanding the molecular pathways of myocardial aging has never been more important. Unraveling these pathways could lead to new therapies for the enormous and growing problem of HFpEF.