Heart failure in elderly patients

Experimental Gerontology
Martin Spiecker

Abstract

Several structural and functional changes contribute to heart failure in elderly patients: an age dependent increase in sympathetic nervous activity, left ventricular wall diameter, myocardial fibrosis and apoptosis, micro- and macrovascular coronary sclerosis, aortic stiffness. As a consequence, diastolic, but also systolic heart failure is a frequent finding in elderly patients. The relation of systolic to diastolic heart failure is clearly shifted towards diastolic heart failure in elderly patients, especially in women. Mortality is increased with systolic dysfunction in elderly patients compared to younger heart failure patients. Mortality is less with diastolic dysfunction, but still higher compared to elderly without heart failure. In addition, morbidity is increased both with diastolic and systolic heart failure in elderly patients. Cognitive dysfunction is a frequent finding. After exclusion of specific cardiac and extracardiac reasons for dyspnoea, drug therapy of systolic heart failure in elderly is similar to younger patients. However, the physiological decrease of renal function and the more frequent renal impairment in elderly patients with heart failure needs to be considered. Guideline recommendations for drug th...Continue Reading

Citations

May 8, 2010·International Urology and Nephrology·Abed BayyaSigal Sviri
Jul 26, 2011·Evidence-based Complementary and Alternative Medicine : ECAM·Si-Yuan PanKam-Ming Ko
Dec 15, 2012·Aging Clinical and Experimental Research·Antonino CatalanoAntonino Lasco
Dec 28, 2010·Journal of the American College of Cardiology·Henry ShihAndrew J Boyle

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