Cardiovascular physiology-changes with aging.
Cardiovascular physiology-changes with aging.
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DOI：
10.1111/j.1076-7460.2003.01751.x
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发表时间：
2003-01-01
期刊：
影响因子：
--
通讯作者：
Cheitlin, Melvin D
中科院分区：
文献类型：
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作者：
Cheitlin, Melvin D
随着年龄的增长，心血管系统会发生变化，从而导致心血管生理学的改变。心血管生理学的变化必须与病理学的影响区分开来，如冠状动脉疾病，随着年龄的增长，发生频率越来越高。这种随年龄的变化发生在每个人身上，但不一定以相同的速度发生，因此解释了一些人的生理年龄和生理年龄之间的差异。与衰老相关的心血管系统的变化是动脉系统的弹性降低和刚度增加。这导致左心室后负荷增加，收缩压升高，左心室肥大，以及左心室壁的其他变化，延长了左心室舒张时间。心房起搏细胞脱落导致固有心率降低。心脏骨骼纤维化时，主动脉瓣底部钙化，穿过右侧纤维三角区的希氏束受损。最后，对β肾上腺素能受体刺激的反应性降低，对压力感受器和化学感受器的反应性降低，循环中的儿茶酚胺增加。这些变化为单纯收缩期高血压、舒张功能障碍和心力衰竭、房室传导缺陷和主动脉瓣钙化奠定了基础，所有这些疾病都见于老年人。
With aging there are changes in the cardiovascular system, which result in alterations in cardiovascular physiology. The changes in cardiovascular physiology must be differentiated from the effects of pathology, such as coronary artery disease, that occur with increasing frequency as age increases. The changes with age occur in everyone but not necessarily at the same rate, therefore accounting for the difference seen in some people between chronologic age and physiologic age. The changes in the cardiovascular system associated with aging are a decrease in elasticity and an increase in stiffness of the arterial system. This results in increased afterload on the left ventricle, an increase in systolic blood pressure, and left ventricular hypertrophy, as well as other changes in the left ventricular wall that prolong relaxation of the left ventricle in diastole. There is a dropout of atrial pacemaker cells resulting in a decrease in intrinsic heart rate. With fibrosis of the cardiac skeleton there is calcification at the base of the aortic valve and damage to the His bundle as it perforates the right fibrous trigone. Finally there is decreased responsiveness to beta adrenergic receptor stimulation, a decreased reactivity to baroreceptors and chemoreceptors, and an increase in circulating catecholamines. These changes set the stage for isolated systolic hypertension, diastolic dysfunction and heart failure, atrioventricular conduction defects, and aortic valve calcification, all diseases seen in the elderly.