[Frontiers in Bioscience E4, 2617-2637, June 1, 2012]

Age related cardiovascular dysfunction and effects of physical activity

Fabio Galetta1, Angelo Carpi2, Nader Abraham3, Emanuele Guidotti1, Matteo A. Russo4, Marcello Camici1, Alessandro Antonelli1, Ferdinando Franzoni1, Gino Santoro1

1Department of Internal Medicine, University of Pisa, Pisa, Italy, 2Department of Reproduction and Ageing, University of Pisa, Pisa, Italy, 3Department of Physiology and Pharmacology, University of Toledo, USA, 4Department of Cellular and Molecular Pathology, IRCCS San Raffaele Pisana, Rome, Italy

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Cardiac ageing
3.1. Molecular and cellular mechanisms of aged cardiomyocytes
3.2. Oxidative stress
3.3. Mitochondrial DNA (mtDNA) mutations
3.4. Impairment of DNA repair
3.5. Accumulation of lipofuscins
3.6. Shortening of telomeres
3.7. Cardiac activation and conduction system
3.8. Ageing and cardiac stem cells
4. Effects of physical activity on the biological mechanisms of cardiac ageing
4.1. Oxidative stress and telomeres
4.2. Effect of physical exercise on cardiac and skeletal muscle
4.3. Effects of physical exercise on cardiac hypertrophy
4.4. Physical activity and EPCs
4.5. Physical activity and CSCs
5. Effect of physical activity on ageing related cardiac dysfunction
5.1. Cardiac remodeling
5.2. Physical activity in preventing arryhthmias
6. Arterial ageing
7. Effect of physical activity on arterial ageing
7.1. Structure and function (vascular remodeling)
7.2. Coronary heart disease
8. Discussion
9. Conclusion
10. References

1. ABSTRACT

The aim of the present article is to review the principal pathogenetic pathways of age-related cardiovascular changes and the positive effects of physical activity on these changes as well as on related cardiovascular dysfunction. The ageing mechanisms reviewed have been grouped into reduced tolerance of oxidative stress, loss of cardiac stem cells, cardiovascular remodeling and impairment of neurovegetative control. New pathogenetic conditions and their tests are described (sirtuines, telomere length, heart rate variability). Age related cardiovascular changes predispose the individual to arterial hypertension, heart failure and arrythmia. A broad spectrum of tests are available to indentify and monitor the emerging cardiovascular dysfunction. Physical activity influences all age related cardiovascular mechanisms, improves cardiovascular function and even, at moderate intensity can reduce mortality and heart attack risk. It is likely that the translation of laboratory studies to humans will improve understanding and stimulate the use of physical activity to benefit cardiovascular patients.