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Aging and Cardiac Fibrosis
Anna Biernacka;Nikolaos G Frangogiannis;
Division of Cardiology, Albert Einstein College of Medicine, Bronx NY, USA ;
Figure 1. Fibrosis of the aging heart. Cardiac aging is associated with significant alterations in cardiac structure and function. Elderly patients often present with left
ventricular hypertrophy and diastolic dysfunction while the systolic function is usually preserved. Age-dependent remodeling of the heart is associated with cardiomyocyte
hypertrophy and interstitial fibrosis. In the normal heart, thin layers of perimysium and endomysium surround myocardial bundles and individual myocytes, respectively. The
walls of the blood vessels also contain adventitial fibroblasts that contribute to the endomysial collagen network. In the senescent heart, there is hypertrophy of
cardiomyocytes, transition of fibroblasts to myofibroblasts and accumulation of extracellular matrix proteins in the interstitium. These alterations lead to perivascular,
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endomysial and perimysial
fibrosis. The histopathologic images show fibrotic remodeling of the heart in aging wild type mice. Picrosirius red staining identifies the collagen
network in the myocardium of 2 mo and 24 mo C57BL6 mice. Senescent hearts S display markedly increased collagen content compared to young hearts Y.