cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2013-4-86-90cardiovascular-220Research ArticleОБЗОРЫREVIEWSСЕРДЦЕ И ВОЗРАСТ (ЧАСТЬ II): КЛИНИЧЕСКИЕ ПРОЯВЛЕНИЯ СТАРЕНИЯHEART AND AGE (PART II): CLINICAL MANIFESTATIONS OF AGEINGАкашеваД. У.AkashevaD. U.

с. н.с. сотрудник отдела комплексного снижения риска неинфекционных заболеваний

Тел.: 8 (903) 526–44–81

dariga-akasheva@yandex.ruПлоховаЕ. В.PlokhovaE. V.

аспирант отдела

СтражескоИ. Д.StrazheskoI. D.

к. м.н., в. н.с. отдела

ДудинскаяЕ. Н.DudinskayaE. N.

к. м.н., н. с. отдела

ТкачеваО. Н.TkachevaO. N.

д. м.н., проф., руководитель отдела

ФГБУ “Государственный научно-исследовательский центр профилактической медицины” Минздрава России, МоскваState Research Centre for Preventive Medicine, Moscow2013200820131248690Copyright © Акашева Д.У., Плохова Е.В., Стражеско И.Д., Дудинская Е.Н., Ткачева О.Н., 20132013Акашева Д.У., Плохова Е.В., Стражеско И.Д., Дудинская Е.Н., Ткачева О.Н.Akasheva D.U., Plokhova E.V., Strazhesko I.D., Dudinskaya E.N., Tkacheva O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/220

Старение – процесс закономерный и неизбежный, ухудшающий качество жизни и сокращающий ее продолжительность. Сердце с возрастом также претерпевает ряд изменений, которые снижают его компенсаторные возможности и способствуют развитию болезни. Такие изменения структуры и функции сердца, наблюдаемые в отсутствие сердечно-сосудистых заболеваний (CCЗ), принято относить к возрастным. Однако, учитывая высокую распространенность ССЗ у пожилых людей, определить истинное старение сердца трудно. В данном обзоре выделен ряд субклинических состояний, которые часто наблюдаются у пожилых людей. 

Ageing is an inevitable process which affects quality of life and reduces life expectancy. Age-related cardiac changes reduce compensatory reserves of the heart and accelerate the disease development. Such changes in cardiac structure and function, observed in the absence of cardiovascular disease (CVD), are considered age-related. However, taking into account the high prevalence of CVD in the elderly, it is problematic to define the genuine cardiac ageing. This review discusses a range of subclinical cardiac conditions which are common in older people. 

старениевозрастные измененияремоделирование миокардасократительная функция сердцаageingage-related changesmyocardial remodellingcardiac contractilityReferencesLakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part I: aging arteries: a “set up” for vascular disease. Circulation 2003; 107: 139–46.Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part I: aging arteries: a “set up” for vascular disease. Circulation 2003; 107: 139–46.Lakatta EG. Age-associated cardiovascular changes in health: impact on cardiovascular disease in older persons. Heart Fail Rev 2002; 7 (1): 29–49.Lakatta EG. Age-associated cardiovascular changes in health: impact on cardiovascular disease in older persons. Heart Fail Rev 2002; 7 (1): 29–49.Dannenberg AL, Levy D, Garrison RJ. Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol 1989; 64: 1066–8.Dannenberg AL, Levy D, Garrison RJ. Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol 1989; 64: 1066–8.Olivetti G, Melissari M, Capasso J, et al. Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy. Circ Res 1991; 68: 1560–8.Olivetti G, Melissari M, Capasso J, et al. Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy. Circ Res 1991; 68: 1560–8.Khouri MG, Maurer MS, El-Khoury Rumbarger L. Assessment of age￾related changes in left ventricular structure and function by freehand three￾dimensional echocardiography. Am J Geriatr Cardiol 2005; 14 (3): 118–25.Khouri MG, Maurer MS, El-Khoury Rumbarger L. Assessment of age￾related changes in left ventricular structure and function by freehand three￾dimensional echocardiography. Am J Geriatr Cardiol 2005; 14 (3): 118–25.Nikitin NP, Loh PH, de Silva R, et al. Left ventricular morphology, global and longitudinal function in normal older individuals: a cardiac magnetic resonance study. Int J Cardiol 2006; 108 (1): 76–83.Nikitin NP, Loh PH, de Silva R, et al. Left ventricular morphology, global and longitudinal function in normal older individuals: a cardiac magnetic resonance study. Int J Cardiol 2006; 108 (1): 76–83.Ganau A, Saba PS, Roman MJ, et al. Ageing induces left ventricular concentric remodeling in normotensive subjects. J Hypertens 1995; 13: 1818–22.Ganau A, Saba PS, Roman MJ, et al. Ageing induces left ventricular concentric remodeling in normotensive subjects. J Hypertens 1995; 13: 1818–22.Hees PS, Fleg JL, Lakatta EG, et al. Left ventricular remodeling with age in normal men versus women: novel insights using three-dimensional magnetic resonance imaging. Am J Cardiol 2002; 90 (11): 1231–6.Hees PS, Fleg JL, Lakatta EG, et al. Left ventricular remodeling with age in normal men versus women: novel insights using three-dimensional magnetic resonance imaging. Am J Cardiol 2002; 90 (11): 1231–6.Lakatta EG. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part III: cellular and molecular clues to heart and arterial aging. Circulation 2003; 107: 490–7.Lakatta EG. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part III: cellular and molecular clues to heart and arterial aging. Circulation 2003; 107: 490–7.Younis LT, Melin JA, Robert AR, et al. In uence of age and sex on left ventricular volumes and ejection fraction during upright exercise in normal subjects. Eur Heart J 1990; 11: 916–24.Younis LT, Melin JA, Robert AR, et al. In uence of age and sex on left ventricular volumes and ejection fraction during upright exercise in normal subjects. Eur Heart J 1990; 11: 916–24.Ruan Q, Nagueh SF. Effect of age on left ventricular systolic function in humans: a study of systolic isovolumic acceleration rate. Exp Physiol 2005; 90 (4): 527–34.Ruan Q, Nagueh SF. Effect of age on left ventricular systolic function in humans: a study of systolic isovolumic acceleration rate. Exp Physiol 2005; 90 (4): 527–34.Oxenham H, Sharpe N. Cardiovascular aging and heart failure. Eur J Heart Fail 2003; 5 (4): 427–34.Oxenham H, Sharpe N. Cardiovascular aging and heart failure. Eur J Heart Fail 2003; 5 (4): 427–34.Stratton JR, Levy WC, Cerqueira MD, et al. Cardiovascular responses to exercise. Effects of aging and exercise training in healthy men. Circulation 1994; 89: 1648–55.Stratton JR, Levy WC, Cerqueira MD, et al. Cardiovascular responses to exercise. Effects of aging and exercise training in healthy men. Circulation 1994; 89: 1648–55.Takeuchi M, Nakai H, Kokumai M, et al. Age-related changes in left ventricular twist assessed by two-dimensional speckle-tracking imaging. J Am Soc Echocardiogr 2006; 19: 1077–84.Takeuchi M, Nakai H, Kokumai M, et al. Age-related changes in left ventricular twist assessed by two-dimensional speckle-tracking imaging. J Am Soc Echocardiogr 2006; 19: 1077–84.Helle-Valle T, Crosby J. New Noninvasive Method for Assessment of Left Ventricular Rotation: Speckle Tracking Echocardiography. Circulation 2005; 112: 3149–56.Helle-Valle T, Crosby J. New Noninvasive Method for Assessment of Left Ventricular Rotation: Speckle Tracking Echocardiography. Circulation 2005; 112: 3149–56.van Dalen BM, Soliman OI, Vletter WB, et al. Insights into left ventricular function from the time course of regional and global rotation by speckle tracking echocardiography. Echocardiography 2009; 26: 371–7.van Dalen BM, Soliman OI, Vletter WB, et al. Insights into left ventricular function from the time course of regional and global rotation by speckle tracking echocardiography. Echocardiography 2009; 26: 371–7.Schirmer H, Lunde P, Rasmussen K. Mitral flow derived Doppler indices of left ventricular diastolic function in a general population; the Tromso study. Eur Heart J 2000; 21: 1376–86.Schirmer H, Lunde P, Rasmussen K. Mitral flow derived Doppler indices of left ventricular diastolic function in a general population; the Tromso study. Eur Heart J 2000; 21: 1376–86.Burlew BS. Diastolic dysfunction in the elderly – the interstitial issue. Am J Geriatr Cardiol 2004; 13: 29–38.Burlew BS. Diastolic dysfunction in the elderly – the interstitial issue. Am J Geriatr Cardiol 2004; 13: 29–38.Lindsey ML, Goshorn DK, Squires CE, et al. Age-dependent changes in myocardial matrix metalloproteinase/tissue inhibitor of metalloproteinase pro les and broblast function. Cardiovasc Res 2005; 66: 410–9.Lindsey ML, Goshorn DK, Squires CE, et al. Age-dependent changes in myocardial matrix metalloproteinase/tissue inhibitor of metalloproteinase pro les and broblast function. Cardiovasc Res 2005; 66: 410–9.Dai DF, Santana LF, Vermulst M, et al. Overexpression of catalase targeted to mitochondria attenuates murine cardiac aging. Circulation 2009; 119: 2789–97.Dai DF, Santana LF, Vermulst M, et al. Overexpression of catalase targeted to mitochondria attenuates murine cardiac aging. Circulation 2009; 119: 2789–97.Little WC, Warner JG, Rankin KM, et al. Evaluation of left ventricular diastolic function from the pattern of left ventricular filling. Clin Cardiol 1998; 21: 5–9.Little WC, Warner JG, Rankin KM, et al. Evaluation of left ventricular diastolic function from the pattern of left ventricular filling. Clin Cardiol 1998; 21: 5–9.Deswal A. Diastolic dysfunction and diastolic heart failure: mechanisms and epidemiology. Curr Cardiol Rep 2005; 7 (3): 178–83.Deswal A. Diastolic dysfunction and diastolic heart failure: mechanisms and epidemiology. Curr Cardiol Rep 2005; 7 (3): 178–83.Spiecker M. Heart failure in elderly patients. Exp Gerontol 2006; 41 (5): 549–51.Spiecker M. Heart failure in elderly patients. Exp Gerontol 2006; 41 (5): 549–51.Kannel WB, Belanger AJ. Epidemiology of heart failure. Am Heart J 1991; 121: 951–7.Kannel WB, Belanger AJ. Epidemiology of heart failure. Am Heart J 1991; 121: 951–7.Rich MW. Heart failure in the 21st century: a cardiogeriatric syndrome. J Gerontol A Biol Sci Med Sci 2001; 56: M88–96.Rich MW. Heart failure in the 21st century: a cardiogeriatric syndrome. J Gerontol A Biol Sci Med Sci 2001; 56: M88–96.Kitzman DW. Diastolic heart failure in the elderly. Heart Fail Rev 2002; 7 (1): 17–27.Kitzman DW. Diastolic heart failure in the elderly. Heart Fail Rev 2002; 7 (1): 17–27.Wong LS, van der Harst P, de Boer RA, et al. Aging, telomeres and heart failure. Heart Fail Rev 2010; 15 (5): 479–86.Wong LS, van der Harst P, de Boer RA, et al. Aging, telomeres and heart failure. Heart Fail Rev 2010; 15 (5): 479–86.van der Harst P, de Boer RA, Samani NJ, et al. Telomere length and outcome in heart failure. Ann Med 2010; 42: 36–44.van der Harst P, de Boer RA, Samani NJ, et al. Telomere length and outcome in heart failure. Ann Med 2010; 42: 36–44.Chimenti C, Kajstura J, Torella D, et al. Senescence and death of primitive cells and myocytes lead to premature cardiac aging and heart failure. Circ Res 2003; 93: 604–13.Chimenti C, Kajstura J, Torella D, et al. Senescence and death of primitive cells and myocytes lead to premature cardiac aging and heart failure. Circ Res 2003; 93: 604–13.Nassimiha D, Aronow WS, Ahn C, et al. Association of coronary risk factors with progression of valvular aortic stenosis in older persons. Am J Cardiol 2001; 87: 1313–4.Nassimiha D, Aronow WS, Ahn C, et al. Association of coronary risk factors with progression of valvular aortic stenosis in older persons. Am J Cardiol 2001; 87: 1313–4.Freeman RV and Otto CM. Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies. Circulation 2005; 111: 3316–26.Freeman RV and Otto CM. Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies. Circulation 2005; 111: 3316–26.Otto CM, Lind BK, Kitzman DW, et al. Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med 1999; 341: 142–7.Otto CM, Lind BK, Kitzman DW, et al. Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med 1999; 341: 142–7.Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: A population-based study. Lancet 2006; 3689: 1005–11.Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: A population-based study. Lancet 2006; 3689: 1005–11.Rajamannan NM, Bonow RO, Rahimtoola SH. Calcific aortic stenosis: An update. Nat Clin Pract Cardiovasc Med 2007; 45: 254–62.Rajamannan NM, Bonow RO, Rahimtoola SH. Calcific aortic stenosis: An update. Nat Clin Pract Cardiovasc Med 2007; 45: 254–62.Drolet MC, Arsenault M, Couet J. Experimental valve stenosis in rabbits. JACC 2003; 41: 1211–7.Drolet MC, Arsenault M, Couet J. Experimental valve stenosis in rabbits. JACC 2003; 41: 1211–7.Rosseb A, Pedersen T, Bomanetal K. Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis. N Engl J Med 2008; 359: 1343–56.Rosseb A, Pedersen T, Bomanetal K. Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis. N Engl J Med 2008; 359: 1343–56.Ngo DT, Sverdlov AL, Willoughby SR, et al. Determinants of occurrence of aortic sclerosis in an aging population. JACC Cardiovasc Imaging 2009; 2 (8): 919–27.Ngo DT, Sverdlov AL, Willoughby SR, et al. Determinants of occurrence of aortic sclerosis in an aging population. JACC Cardiovasc Imaging 2009; 2 (8): 919–27.Owens DS, Otto CM. Is it time for a new paradigm in calcific aortic valve disease? JACC Cardiovasc Imaging 2009; 2 (8): 928–30.Owens DS, Otto CM. Is it time for a new paradigm in calcific aortic valve disease? JACC Cardiovasc Imaging 2009; 2 (8): 928–30.Kurz DJ, Kloeckener-Gruissem B, Akhmedov A, et al. Degenerative aortic valve stenosis, but not coronary disease, is associated with shorter telomere length in the elderly. Arterioscler Thromb Vasc Biol 2006; 26: e114–7.Kurz DJ, Kloeckener-Gruissem B, Akhmedov A, et al. Degenerative aortic valve stenosis, but not coronary disease, is associated with shorter telomere length in the elderly. Arterioscler Thromb Vasc Biol 2006; 26: e114–7.Nassimiha D, Aronow WS, Ahn C, et al. Association of coronary risk factors with progression of valvular aortic stenosis in older persons. Am J Cardiol 2001; 87: 1313–4.Nassimiha D, Aronow WS, Ahn C, et al. Association of coronary risk factors with progression of valvular aortic stenosis in older persons. Am J Cardiol 2001; 87: 1313–4.Dao-Fu Dai, Tony Chen, SimonC. Johnson, et al. Cardiac Aging: From Molecular Mechanisms to Significance in Human Health and Disease. Antioxidants & Redox Signaling 2012; 16 (12): 1492–526.Dao-Fu Dai, Tony Chen, SimonC. Johnson, et al. Cardiac Aging: From Molecular Mechanisms to Significance in Human Health and Disease. Antioxidants & Redox Signaling 2012; 16 (12): 1492–526.Guize L, Piot O, Lavergne T, et al. Cardiac arrhythmias in the elderly. Bull Acad Natl Med 2006; 190 (4–5): 827–41.Guize L, Piot O, Lavergne T, et al. Cardiac arrhythmias in the elderly. Bull Acad Natl Med 2006; 190 (4–5): 827–41.Manolio TA, Furberg CD, Rautaharju PM, et al. Cardiac arrhythmias on 24-hr ambulatory electrocardiography in older women and men: The Cardiovascular Health Study. JACC 1994; 23: 916–25.Manolio TA, Furberg CD, Rautaharju PM, et al. Cardiac arrhythmias on 24-hr ambulatory electrocardiography in older women and men: The Cardiovascular Health Study. JACC 1994; 23: 916–25.Yanni J, Tellez JO, Sutyagin PV, et al. Structural remodelling of the sinoatrial node in obese old rats. J Mol Cell Cardiol 2010; 48 (4): 653–62.Yanni J, Tellez JO, Sutyagin PV, et al. Structural remodelling of the sinoatrial node in obese old rats. J Mol Cell Cardiol 2010; 48 (4): 653–62.Pollock ML, Mengelkoch LJ, Graves JE, et al. Twenty-year follow-up of aerobic power and body composition of older track athletes. J Appl Physiol 1997; 82 (5): 1508–16.Pollock ML, Mengelkoch LJ, Graves JE, et al. Twenty-year follow-up of aerobic power and body composition of older track athletes. J Appl Physiol 1997; 82 (5): 1508–16.Kusumoto FM, Phillips R, Goldschlager N. Pacing therapy in the elderly. Am J Geriatr Cardiol 2002; 11: 305–16.Kusumoto FM, Phillips R, Goldschlager N. Pacing therapy in the elderly. Am J Geriatr Cardiol 2002; 11: 305–16.Lamas GA, Lee K, Sweeney M, et al. The Mode Selection Trial (MOST) in sinus node dysfunction: design, rationale, and baseline characteristics of the first 1000 patients. Am Heart J 2000; 140: 541–51.Lamas GA, Lee K, Sweeney M, et al. The Mode Selection Trial (MOST) in sinus node dysfunction: design, rationale, and baseline characteristics of the first 1000 patients. Am Heart J 2000; 140: 541–51.Craft N, Schwartz JB. Effects of age on intrinsic heart rate, heart rate variability, and AV conduction in healthy humans. Am J Physiol 1995; 268: H1441–52.Craft N, Schwartz JB. Effects of age on intrinsic heart rate, heart rate variability, and AV conduction in healthy humans. Am J Physiol 1995; 268: H1441–52.Gosse P, Coulon P, Papaioannou G, et al. Atrioventricular conduction in the hypertensive patient: influence of aging, pulse pressure, and arterial stiffness. Rejuvenation Res 2011; 14 (4): 405–10.Gosse P, Coulon P, Papaioannou G, et al. Atrioventricular conduction in the hypertensive patient: influence of aging, pulse pressure, and arterial stiffness. Rejuvenation Res 2011; 14 (4): 405–10.Ikolaos Fragakis, George Katsaris. Arrhythmias in the Elderly. Modern Management. Hellenic J Cardiol 2006; 47: 84–92.Ikolaos Fragakis, George Katsaris. Arrhythmias in the Elderly. Modern Management. Hellenic J Cardiol 2006; 47: 84–92.Nicolini P, Ciulla MM, De Asmundis C, et al. The prognostic value of heart rate variability in the elderly, changing the perspective: from sympathovagal balance to chaos theory. Pacing Clin Electrophysiol 2012; 35 (5): 622–38.Nicolini P, Ciulla MM, De Asmundis C, et al. The prognostic value of heart rate variability in the elderly, changing the perspective: from sympathovagal balance to chaos theory. Pacing Clin Electrophysiol 2012; 35 (5): 622–38.Lakatta EG, Levy D. Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises. Part II: The Aging Heart in Health: Links to Heart Disease. Circulation 2003; 107: 346–54.Lakatta EG, Levy D. Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises. Part II: The Aging Heart in Health: Links to Heart Disease. Circulation 2003; 107: 346–54.Heeringa J, van der Kuip DA, Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 2006; 27: 949–53.Heeringa J, van der Kuip DA, Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 2006; 27: 949–53.Allessie MA, Boyden PA, Camm AJ, et al. Pathophysiology and prevention of atrial fibrillation. Circulation 2001; 103: 769–77.Allessie MA, Boyden PA, Camm AJ, et al. Pathophysiology and prevention of atrial fibrillation. Circulation 2001; 103: 769–77.Jais P, Peng JT, Shah DC, et al. Left ventricular diastolic dysfunction in patients with so-called lone atrial fibrillation. J Cardiovasc Electrophysiol 2000; 11: 623–5.Jais P, Peng JT, Shah DC, et al. Left ventricular diastolic dysfunction in patients with so-called lone atrial fibrillation. J Cardiovasc Electrophysiol 2000; 11: 623–5.Tsang TS, Barnes ME, Gersh BJ, et al. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 2002; 90 (12): 1284–9.Tsang TS, Barnes ME, Gersh BJ, et al. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 2002; 90 (12): 1284–9.Yamada T, Fukunami M, Shimonagata T, et al. Prediction of paroxysmal atrial fibrillation in patients with congestive heart failure: a prospective study. JACC 2000; 35: 405–13.Yamada T, Fukunami M, Shimonagata T, et al. Prediction of paroxysmal atrial fibrillation in patients with congestive heart failure: a prospective study. JACC 2000; 35: 405–13.

The authors declare that there are no conflicts of interest present.