Does Cardiac Physiology also Take Age in Geriatric Population?

Year 2021, , 93 - 102, 31.12.2021

Ebru Gülek Karadüz , Ufuk Yurdalan

https://doi.org/10.47141/geriatrik.1022619

Abstract

Aging is a process characterized by a decreasing anabolic metabolism and regeneration capacity of the body, leading to irreversible changes in structure and functions. As the older population increases globally, recent studies have focused on a better understanding of the aging changes in the cardiac structure causing mortality and morbidity. It was proven that physiological changes with aging are the leading risk factor for cardiovascular diseases. This review aims to examine cellular mechanisms and investigate changes in the cardiac structure and physiology with the aging process in light of current information. Many theories explain cellular and molecular changes that play a significant role in aging. Decreased autophagy, increased mitochondrial oxidative stress, telomere length changes, mitochondrial dysfunction, changes in mTOR signals, errors in RNA coding, increase in cardiac fibrosis, altered Insulin Like-Growth Factor is fundamental accepted cellular theories currently. As a result of these processes at the cellular level, the effects of aging are seen as structural-functional differentiations in the myocardium, cardiovascular and nervous systems. Changes in the vascular system begin in endothelial cells, and the loss of vascular elasticity over time paves the way for basic functional changes. In addition, hypertrophy of the myocardium and blockages resulting from autonomic nervous system dysfunction are the most notable changes. Cardiovascular diseases such as cardiac hypertrophy, arrhythmia, and heart failure are the major problems as a result of these changes. Studies have also proven that the incidence of the diseases increases in parallel with age. It is thought that a better understanding of the consequences of the cardiac aging process will contribute to both promoting the healthy aging process and presenting more effective methods in the treatment of cardiovascular diseases for older individuals.

Keywords

Aging, heart, myocardium, geriatrics

Geriatrik Popülasyonda Kardiyak Fizyoloji de Yaş Alır mı?

Abstract

Yaşlanma, vücudun anabolik metabolizmasında ve rejenerasyon kapasitesinde azalma ile karakterize, yapı ve fonksiyonlarda geri dönüşümsüz değişikliklere yol açan bir süreçtir. Dünya üzerinde yaşlı nüfusun her geçen gün artması nedeniyle son yıllardaki çalışmalar, yaşlanma sürecinde mortalite ve morbiditeye sebep olan kardiyak yapıdaki değişikliklerin daha iyi anlaşılması üzerine yoğunlaşmıştır. Bu derlemedeki amaç; kardiyak yaşlanma sürecindeki hücresel mekanizmaları güncel bilgiler ışığında ele alırken, yaşlanma sürecinde görülen kardiyak yapı ve fizyolojisindeki değişimleri de bir arada incelemektir. Kardiyak yaşlanmada rol oynayan hücresel ve moleküler değişimler birçok teori ile açıklanmaktadır. Güncel olarak kardiyak yaşlanma sürecinde rol oynadığı kabul edilen temel hücresel teoriler arasında azalmış otofaji, artmış mitokondrial oksidatif stres, telomer boyundaki değişiklikler, mitokondrial disfonksiyon, mTOR sinyallerindeki değişimler, RNA kodlamalarındaki hatalar, kardiyak fibroziste artış, değişmiş İnsülin Like-Growth Factor gösterilmektedir. Hücre düzeyinde meydana gelen bu süreçler sonucunda ise yaşlanmanın etkileri kardiyovasküler, kalp kası ve sinir sisteminde yapısal-fonksiyonel farklılaşmalar olarak görülür. Vasküler sistemde değişiklikler endotel hücrelerde başlar ve zamanla vasküler elastikiyetin kaybedilmesi temel fonksiyonel değişikliklere zemin hazırlar. Ayrıca miyokardiyumda hipertrofik değişimler, otonom sinir sistemi disfonksiyonu sonucunda gelişen blokajlar en belirgin değişikliklerdir. Kardiyak hipertrofi, aritmi ve kalp yetmezliği gibi kardiyovasküler hastalıklar ise bu değişiklikler sonucunda görülen major problemlerdir. Bu hastalıkların yaşa paralel olarak görülme sıklığında artış gösterdiği de çalışmalarda kanıtlanmıştır. Kardiyak yaşlanma sürecinin daha iyi anlaşılmasının, yaşlı bireylere hem sağlıklı yaşlanma sürecinin teşvik edilmesine hem de kardiyovasküler hastalıkların tedavisinde daha etkin tedavi yöntemlerinin sunulmasına katkı sağlayacağı düşünülmektedir.

Keywords

yaşlanma, kalp, miyokardiyum, geriatri

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