What lies ahead: he is the best physician who is the most ingenious inspirer of hope.[ILLUSTRATION OMITTED]
In 1903, Dutch physiologist Willem Einthoven, MD, PhD invented the electrocardiograph e·lec·tro·car·di·o·graph
n. Abbr. ECG, EKG
An instrument used in the detection and diagnosis of heart abnormalities that measures electrical potentials on the body surface and generates a record of the electrical currents associated with , a machine that measures the minute electrical currents generated by the heart. Initially, it was a cumbersome and costly device, taking five technicians to operate. During the procedure, patients had to place both hands and both feet in buckets of water. But as a result of this advance cardiologists began, for the first time, to fully understand the electrical processes involved in generating the heart beat. With this knowledge, they were able to more precisely diagnosis certain cardiovascular problems.
A little more than a century later, scientific ingenuity has led to the development of many other advances. Scientists, for instance, have developed magnetic resonance imaging magnetic resonance imaging (MRI), noninvasive diagnostic technique that uses nuclear magnetic resonance to produce cross-sectional images of organs and other internal body structures. and other noninvasive ways to study the aging heart. Researchers have discovered a host of innovative drug treatments to help the ailing heart and arteries work better. And cardiologists and surgeons have successfully pioneered the use of cardiac catheterization, cardiovascular stents, implantable pacemakers, bypass surgery, and heart transplants.
No doubt about it, doctors know more about the heart and how to keep it healthy than at any other time in history. In just the past 30 years, gerontologists have revolutionized ideas about what happens in the older heart. They've learned, for instance, that age-related changes in the structure and function of the heart occur in virtually every person. Mounting evidence suggests that some of these changes, previously thought to be a part of normal aging, precede and predict the onset of cardiovascular diseases, even among those who do not yet have signs or symptoms of disease. But they've also learned that preventive measures, such as getting regular exercise, eating a healthy diet, and not using tobacco, can have a profound impact on the aging cardiovascular system.
In the future, interventions to slow accelerated aging of the heart and arteries in apparently healthy young and middle-age people could prevent or delay the onset of heart disease, stroke, and other cardiovascular disorders in later life, Dr. Lakatta says. These interventions may take many forms. For instance, the more we understand about the changes that take place in cells and molecules during aging, the closer we get to the possibility of designing drugs targeted to those changes. Gene therapies can also target specific cellular changes and could potentially be a way to intervene in the aging process.
Achieving these goals will likely require considerable effort and as much, or perhaps even more, ingenuity and innovation in the coming years as has been shown in the past. NIA NIA National Institute on Aging (NIH)
NIA National Indoor Arena (UK)
NIA National Intelligence Agency (South Africa and Thailand)
NIA National Institute of Accountants investigators and others are already taking steps to meet these challenges. They still have many questions to answer and mysteries to solve. But as this work progresses and scientists unravel more of the aging heart's secrets, the hope of forestalling cardiovascular disease and improving the quality of life for older people may come closer to reality.
ACTION POTENTIAL--An abrupt, transient change in the electrical charge along a heart muscle cell membrane; the first of several steps leading to the cell's contraction.
ADVENTITIA--The outermost layer of arterial wall; it is composed of connective tissue.
AFTERLOAD--The mechanical load encountered by the heart following the onset of contraction; the forces that resist the flow of blood from the heart. The afterload may increase with age due to increasingly stiff arteries and an increased tone of the smaller arteries.
ANGIOTENSIN--A chemical that constricts blood vessels, which raises blood pressure.
AORTA--The largest artery in the body. It conducts blood away from the heart, then branches into many smaller arteries that take blood to the rest of the body. The diameter of the aorta enlarges with age and its walls become stiffer.
ARTERIES--Blood vessels that carry blood away from the heart to all parts of the body. Some enlarge with age and become thicker and stiffer. Arterial walls consist of three layers: the intima intima /in·ti·ma/ (in´ti-mah)
2. tunica intima vasorum.in´timal
n. pl. , media, and adventitia adventitia /ad·ven·ti·tia/ (ad?ven-tish´e-ah)
2. tunica adventitia.
ARTERIOLES--The very small arteries that take blood from the arteries to the capillaries.
ATHEROSCLEROSIS--A condition of the arteries in which the interior of the artery wall is made thick and irregular by deposits of fatty substances and invasive cells from the blood and arterial wall and matrix substances synthesized by the cells.
ATRIOVENTRICULAR atrioventricular /atrio·ven·tric·u·lar/ (-ven-trik´u-ler) pertaining to both an atrium and a ventricle of the heart.
adj. Abbr. NODE--A group of special conduction fibers at the base of the wall between the right atrium and ventricle ventricle /ven·tri·cle/ (ven´tri-k'l) a small cavity or chamber, as in the brain or heart.ventric´ular
ventricle of Arantius the rhomboid fossa, especially its lower end. . They relay the electrical impulses to the ventricle to initiate contraction. These electrical impulses originate in the heart's pacemaker, the sinoatrial node within the right atrium.
ATRIUM--One of the two upper chambers of the heart. The right atrium receives blood depleted of oxygen from the veins; the left atrium receives blood with fresh oxygen from the lungs. The left atrial cavity enlarges with age.
AUTONOMIC NERVOUS SYSTEM--That part of the nervous system that controls involuntary muscles, such as the heart. It uses chemicals, such as catecholamines Catecholamines
Family of neurotransmitters containing dopamine, norepinephrine and epinephrine, produced and secreted by cells of the adrenal medulla in the brain. , to send messages from the brain to the heart. With age, the body's response to cathecholamines withers.
BARORECEPTOR baroreceptor /baro·re·cep·tor/ (-re-sep´ter) a type of interoceptor that is stimulated by pressure changes, as those in blood vessel walls.
bar·o·re·cep·tor or bar·o·cep·tor
n. RESPONSE--The body's response to pressure sensitive nerves in the carotid artery that help regulate heart rate and arterial pressure; the response grows weaker with age.
BLOOD PRESSURE--The force that flowing blood exerts against artery walls. Systolic blood pressure Systolic blood pressure
Blood pressure when the heart contracts (beats).
Mentioned in: Hypertension occurs when the heart contracts and pumps blood into the aorta. Diastolic blood pressure Diastolic blood pressure
Blood pressure when the heart is resting between beats.
Mentioned in: Hypertension occurs when the aortic valve closes and the heart relaxes and refills with blood.
CALCIUM PUMP PROTEINS--Proteins on the sarcoplasmic reticulum that remove calcium from the cell cytosol cytosol /cy·to·sol/ (sit´ah-sol) the liquid medium of the cytoplasm, i.e., cytoplasm minus organelles and nonmembranous insoluble components.cytosol´ic
n. after a contraction. The number of these pump proteins declines with age.
CALCIUM TRANSIENT--The transient increase in calcium in the cytosol following excitation, which causes a contraction. It grows longer with age.
CAPILLARIES--The smallest blood vessels that take blood from the arterioles Arterioles
Small blood vessels that carry arterial (oxygenated) blood.
Mentioned in: Retinal Artery Occlusion
n to cells in the body.
CARDIAC CYCLE--The cycle of synchronized activities that occurs during one heart beat.
CARDIAC OUTPUT--The amount of blood a heart pumps each minute. It is calculated by multiplying heart rate by stroke volume.
CARDIOVASCULAR--Of or pertaining to the heart and blood vessels.
CHEMOKINES--A type of cytokine that carries messages between cells. In a sense, they tell cells where to go. If chemokines are increased in a particular tissue, such as an artery, the cell with the receptor, or partner, for that particular molecule is attracted to move into that tissue.
CHOLESTEROL--A waxy, fat-like substance present in cell walls or membranes everywhere in the body, including the heart. Excess cholesterol is deposited in arteries, including the coronary arteries, where it contributes to the narrowing and blockages that cause the signs and symptoms of heart disease. Cholesterol is carried in small packages called low density (LDL LDL - ["LDL: A Logic-Based Data-Language", S. Tsur et al, Proc VLDB 1986, Kyoto Japan, Aug 1986, pp.33-41]. ) and high density (HDL (Hardware Description Language) A language used to describe the functions of an electronic circuit for documentation, simulation or logic synthesis (or all three). Although many proprietary HDLs have been developed, Verilog and VHDL are the major standards. ) lipoproteins.
CONTRACTILE contractile /con·trac·tile/ (kon-trak´til) able to contract in response to a suitable stimulus.
Capable of contracting or causing contraction, as a tissue. (MYOFILAMENT myofilament /myo·fila·ment/ (-fil´ah-ment) any of the ultramicroscopic threadlike structures composing the myofibrils of striated muscle fibers; thick ones contain myosin, thin ones contain actin, and intermediate ones contain desmin and ) PROTEINS--Proteins in myocytes that change their configuration in order to bring about a shortening or contraction of the cell. This may change with age.
CONTRACTILE STATE--The ability of the heart muscle cells to contract, also referred to as contractility contractility /con·trac·til·i·ty/ (kon?trak-til´i-te) capacity for becoming shorter in response to a suitable stimulus.
a capacity for becoming short in response to suitable stimulus. .
CORONARY HEART DISEASE--Also called coronary artery disease coronary artery disease, condition that results when the coronary arteries are narrowed or occluded, most commonly by atherosclerotic deposits of fibrous and fatty tissue. ischemic heart disease Ischemic heart disease
Insufficient blood supply to the heart muscle (myocardium).
Mentioned in: Myocarditis
ischemic heart disease . A narrowing of the coronary arteries due mostly to atherosclerosis resulting in a decreased flow of blood to the heart muscle and thus lower levels of oxygen reaching the heart.
CORONARY FLOW--The flow of blood through the coronary arteries that nourish the heart muscle.
CYTOKINE--Proteins that are secreted by cells and regulate the behavior of other cells by binding to receptors on their surfaces. This binding triggers a variety of responses depending on the nature of the cytokine and the target cell.
CYTOSOL--The fluid inside heart and blood vessel cells.
DIASTOLE--The period during a heart beat when the chambers are filling with blood and the heart muscle is relaxed.
DNA--Abbreviation for deoxyribonucleic acid, the molecule that contains the genetic code for all life forms except for a few viruses. It consists of two long, twisted chains of molecules in the nucleus of each cell that carries the genetic information necessary for all cellular functions, including the building of proteins.
A visual record produced by echocardiography.
A non-invasive ultrasound test that shows an image of the inside of the heart. (ECG OR EKG ECG or EKG
A record of the waves that relates to the electrical impulses produced at each beat of the heart.
Mentioned in: Electrocardiography )--A visual record of the heart's electrical activity.
EJECTION FRACTION--The fraction of end diastolic Diastolic
The phase of blood circulation in which the heart's pumping chambers (ventricles) are being filled with blood. During this phase, the ventricles are at their most relaxed, and the pressure against the walls of the arteries is at its lowest. volume pumped out with each beat.
ELECTROCARDIOGRAPHY--A method of graphically recording the structure and movement of the heart by the echo caused by beams of ultrasonic waves.
END DIASTOLIC VOLUME--The volume of blood in the left ventricle at the end of diastole diastole /di·as·to·le/ (di-as´tah-le) the dilatation, or the period of dilatation, of the heart, especially of the ventricles.diastol´ic
n. , just before the next beat.
ENDOTHELIUM--The smooth inner lining of many body structures, including the heart and blood vessels. Endothelial cells are a primary component of the intima.
END SYSTOLIC Systolic
The phase of blood circulation in which the heart's pumping chambers (ventricles) are actively pumping blood. The ventricles are squeezing (contracting) forcefully, and the pressure against the walls of the arteries is at its highest. VOLUME--The volume of blood left in the heart at the end of the heartbeat.
ENZYME--A protein that promotes a specific biochemical reaction in the body without itself being permanently changed or destroyed. Enzymes may have an important role in the age-associated changes in structure and function that occur in the heart and arteries.
FRANK-STARLING LAW OF THE HEART--A phenomenon in which the more the heart muscle is stretched the more vigorously it contracts.
FREE RADICALS--Molecules with unpaired electrons that react readily with other molecules. Free radicals can damage myocytes as well as the membranes and DNA DNA: see nucleic acid.
or deoxyribonucleic acid
One of two types of nucleic acid (the other is RNA); a complex organic compound found in all living cells and many viruses. It is the chemical substance of genes. of endothelial cells in the intima and smooth muscle cells in the media. This damage can promote stiffening and thickening of arterial walls. Free radicals also can contribute to atherosclerotic plaque build up.
GENE--A segment of DNA that codes for a specific protein or other molecule. Each gene contains a specific sequence of chemicals. The sequence is referred to as a "code" because it specifies the order of amino acids (chemical building blocks of proteins) in the end product.
GENE EXPRESSION--The process by which the information contained in genes is transcribed and translated into proteins. Age-related changes in gene expression may account for some changes in heart and artery function.
HEART ATTACK--The death of a portion of heart muscle, resulting when an obstruction in one of the coronary arteries prevents an adequate oxygen supply to that muscle. Heart attacks may be referred to in terms of obstruction (coronary thrombosis) or in terms of the damage done (myocardial infarction).
HEART FAILURE--A condition in which the heart is unable to pump the amount of blood needed by the body. Heart failure can develop from many heart and circulatory disorders, such as high blood pressure heart attack. It often leads to congestion The condition of a network when there is not enough bandwidth to support the current traffic load.
congestion - When the offered load of a data communication path exceeds the capacity. in the body tissues, with fluid accumulating in the abdomen and legs and/or in the lungs. This condition is often called congestive heart failure congestive heart failure, inability of the heart to expel sufficient blood to keep pace with the metabolic demands of the body. In the healthy individual the heart can tolerate large increases of workload for a considerable length of time. .
HEART RATE--The number of beats per minute beats per minute Cardiac pacing The unit of measure for the frequency of heart depolarizations or contractions each minute–or pulse rate .
HIGH BLOOD PRESSURE--An unstable or persistent elevation of blood pressure above the normal range. Blood pressure often increases with age. High blood pressure increases the risk of heart disease and stroke; also known as hypertension.
HIGH DENSITY LIPOPROTEINS (HDL)--The "good" cholesterol. HDL carries cholesterol in the blood from other parts of the body back to the liver, which leads to its removal from the body. HDL helps keep cholesterol from building up in the walls of the arteries.
HYPERTROPHY--Enlarge or enlargement. The myocytes that make up the walls of the heart hypertrophy hypertrophy (hīpûr`trəfē), enlargement of a tissue or organ of the body resulting from an increase in the size of its cells. Such growth accompanies an increase in the functioning of the tissue. with age.
ISCHEMIA--Decreased blood supply to the heart muscle.
INTIMA--The innermost layer of arterial wall closest to the blood. It is composed of a single layer of specialized cells, called endothelial cells, which sit atop the sub-endothelial space and a wall called the basement membrane.
LOW DENSITY LIPOPROTEIN Low density lipoprotein (LDL)
A fraction of total serum lipids, the so called "bad" cholesterol.
Mentioned in: Hypercholesterolemia (LDL)--The "bad" cholesterol.High LDL cholesterol leads to a build up of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have for getting coronary heart disease coronary heart disease: see coronary artery disease.
coronary heart disease
or ischemic heart disease
Progressive reduction of blood supply to the heart muscle due to narrowing or blocking of a coronary artery (see atherosclerosis). .
LUMEN--The tube-like opening in arteries and other vessels that blood flows through on its journey throughout the body.
MAXIMUM HEART RATE--The number of beats per minute during rigorous exercise. It declines by about 25 to 30 percent between the ages 20 and 80, regardless of physical fitness status. Scientists estimate maximum heart rate by subtracting your age from 220.
MAXIMUM OXYGEN CONSUMPTION--The amount of oxygen used by the body at peak exercise capacity. Also known as VO2 max, it is considered the best measure of cardiorespiratory physical fitness. Women tend to have less lean muscle mass than men, and it is lean muscle mass that needs the most oxygen. When studies compare oxygen consumption based on the amount of lean muscle rather than overall body size, the gender differences disappear. Women, in other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently , use the same amount of oxygen as men.
MEDIA--The middle layer of the arterial wall. It is composed of smooth muscle cells surrounded by a network of fibers primarily made of two proteins, collagen, and elastin elastin /elas·tin/ (e-las´tin) a yellow scleroprotein, the essential constituent of elastic connective tissue; it is brittle when dry, but when moist is flexible and elastic.
n. . The elastin forms concentric rings within the vessel wall.
MITRAL mitral /mi·tral/ (mi´tril) shaped like a miter; pertaining to the mitral valve.
1. Relating to a mitral valve.
2. Shaped like a bishop's miter. VALVE--The valve between the left atrium and ventricle. It closes more slowly with age because the rate of blood flow into the left ventricle that pushes it closed decreases with age.
MYOCARDIUM--The heart muscle.
MYOCYTE--A heart muscle cell.Myocytes decline in number but grow larger with age.
NONINVASIVE TECHNIQUES--Medical procedures that do not require needle puncture, surgery, or entering the artery.
ORGANELLE--A structure inside a cell, such as the sarcoplasmic reticulum.
OXYGEN CONSUMPTION--The amount of oxygen the entire body uses in a certain time period. It is calculated by taking the amount of oxygen in the arteries and subtracting the amount left in the veins after the body's cells have taken out oxygen. The result is then multiplied by cardiac output.
PRELOAD--The amount of blood in the left ventricle before contraction.
PROTEINS--Molecules composed of amino acids arranged in a specific order. Certain proteins, such as the calcium pump protein and the contractile protein myosin myosin (mī`əsĭn), one of the two major protein constituents responsible for contraction of muscle. In muscle cells myosin is arranged in long filaments called thick filaments that lie parallel to the microfilaments of actin. , appear to change with age which may account for some alterations in the function of the aging heart.
pertaining to or emanating from sarcoplasm.
include a number of organelles associated with sarcoplasm. RETICULUM--A structure or organelle organelle /or·ga·nelle/ (or?gah-nel´) a specialized structure of a cell, such as a mitochondrion, Golgi complex, lysosome, endoplasmic reticulum, ribosome, centriole, chloroplast, cilium, or flagellum. inside a myocyte. Its function is to store and release calcium for use during a contraction and to remove calcium after calcium transient causes a contraction. It removes calcium more slowly with age.
SINOATRIAL sinoatrial /si·no·atri·al/ (si?no-a´tre-al) pertaining to the sinus venosus and the atrium of the heart.
si·no·a·tri·al or si·nu·a·tri·al
adj. Abbr. NODE--The heart's pacemaker. A group of specialized cells in the right atrium wall that give rise to the electrical impulses that initiate contractions.
STROKE VOLUME--The amount of blood pumped with each heart beat.
SYSTOLE--The period during a heart beat when the heart muscle contracts and blood is pumped out.
VEINS--The blood vessels that return blood to the heart after the body's cells have extracted oxygen.
VENTRICLE--A chamber of the heart that pumps blood out. The right ventricle pumps blood to the lungs where it picks up oxygen; the left ventricle pumps blood into the aorta, which distributes it to the rest of the body.
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Balsam balsam (bôl`səm), fragrant resin obtained from various trees. The true balsams are semisolid and insoluble in water, but they are soluble in alcohol and partly so in hydrocarbons. , L.B.; Wagers, A.J.; Christensen, J.L., et al. (2004).Haematopoietic Adj. 1. haematopoietic - pertaining to the formation of blood or blood cells; "hemopoietic stem cells in bone marrow"
haematogenic, haemopoietic, hematogenic, hematopoietic, hemopoietic Stem Cells Adopt Mature Haematopoietic Fates in Ischaemic Adj. 1. ischaemic - relating to or affected by ischemia
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SAMUEL TAYLOR COLERIDGE, ENGLISH POET AND PHILOSOPHER, 1772-1834