# The Role of Oxidative Stress in the Aging Heart

**Authors:** Luana U Pagan, Mariana J Gomes, Mariana Gatto, Gustavo A F Mota, Katashi Okoshi, Marina P Okoshi

PMC · DOI: 10.3390/antiox11020336 · 2022-02-09

## TL;DR

This paper reviews how oxidative stress contributes to the aging heart and highlights molecular pathways that could help prevent age-related heart disease.

## Contribution

The paper provides a comprehensive review of oxidative stress and redox signaling in cardiac aging, emphasizing potential molecular targets for intervention.

## Key findings

- Oxidative stress from imbalanced ROS production and antioxidant defenses contributes to cardiac aging.
- ROS activates pathways leading to myocyte hypertrophy, fibrosis, and inflammation in the heart.
- Dysfunctional mitochondria and metabolic changes are key factors in age-related cardiac decline.

## Abstract

Medical advances and the availability of diagnostic tools have considerably increased life expectancy and, consequently, the elderly segment of the world population. As age is a major risk factor in cardiovascular disease (CVD), it is critical to understand the changes in cardiac structure and function during the aging process. The phenotypes and molecular mechanisms of cardiac aging include several factors. An increase in oxidative stress is a major player in cardiac aging. Reactive oxygen species (ROS) production is an important mechanism for maintaining physiological processes; its generation is regulated by a system of antioxidant enzymes. Oxidative stress occurs from an imbalance between ROS production and antioxidant defenses resulting in the accumulation of free radicals. In the heart, ROS activate signaling pathways involved in myocyte hypertrophy, interstitial fibrosis, contractile dysfunction, and inflammation thereby affecting cell structure and function, and contributing to cardiac damage and remodeling. In this manuscript, we review recent published research on cardiac aging. We summarize the aging heart biology, highlighting key molecular pathways and cellular processes that underlie the redox signaling changes during aging. Main ROS sources, antioxidant defenses, and the role of dysfunctional mitochondria in the aging heart are addressed. As metabolism changes contribute to cardiac aging, we also comment on the most prevalent metabolic alterations. This review will help us to understand the mechanisms involved in the heart aging process and will provide a background for attractive molecular targets to prevent age-driven pathology of the heart. A greater understanding of the processes involved in cardiac aging may facilitate our ability to mitigate the escalating burden of CVD in older individuals and promote healthy cardiac aging.

## Linked entities

- **Diseases:** cardiovascular disease (MONDO:0004995)

## Full-text entities

- **Genes:** NOX3 (NADPH oxidase 3) [NCBI Gene 50508] {aka GP91-3, MOX-2}, CYTB (cytochrome b) [NCBI Gene 4519] {aka MTCYB}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, DUOXA1 (dual oxidase maturation factor 1) [NCBI Gene 90527] {aka NIP, NUMBIP, mol}, CAT (catalase) [NCBI Gene 847], Mst1 (macrophage stimulating 1 (hepatocyte growth factor-like)) [NCBI Gene 15235] {aka D3F15S2h, D9H3F15S2, DNF15S2h, Hgfl}, SIRT1 (sirtuin 1) [NCBI Gene 23411] {aka SIR2, SIR2L1, SIR2alpha}, Sirt1 (sirtuin 1) [NCBI Gene 93759] {aka SIR2L1, Sir2, Sir2a, Sir2alpha}, NDUFS7 (NADH:ubiquinone oxidoreductase core subunit S7) [NCBI Gene 374291] {aka CI-20, CI-20KD, MC1DN3, MY017, PSST}, NOS1 (nitric oxide synthase 1) [NCBI Gene 4842] {aka IHPS1, N-NOS, NC-NOS, NOS, bNOS, nNOS}, NOS3 (nitric oxide synthase 3) [NCBI Gene 4846] {aka EC-NOS, ECNOS, MYMY8, NOSIII, cNOS, eNOS}, Nos3 (nitric oxide synthase 3, endothelial cell) [NCBI Gene 18127] {aka 2310065A03Rik, Nos-3, eNOS, ecNOS}, RAC2 (Rac family small GTPase 2) [NCBI Gene 5880] {aka EN-7, Gx, HSPC022, IMD73A, IMD73B, IMD73C}, DUOXA2 (dual oxidase maturation factor 2) [NCBI Gene 405753] {aka SIMNIPHOM, TDH5}, NEK4 (NIMA related kinase 4) [NCBI Gene 6787] {aka NRK2, STK2, pp12301}, NCF2 (neutrophil cytosolic factor 2) [NCBI Gene 4688] {aka NCF-2, NOXA2, P67-PHOX, P67PHOX}, CYBB (cytochrome b-245 beta chain) [NCBI Gene 1536] {aka AMCBX2, CGD, CGDX, GP91-1, GP91-PHOX, GP91PHOX}, NFE2L2 (NFE2 like bZIP transcription factor 2) [NCBI Gene 4780] {aka IMDDHH, NRF2, Nrf-2}, NCF1 (neutrophil cytosolic factor 1) [NCBI Gene 653361] {aka CGD1, NCF-1, NCF-47K, NCF1A, NOXO2, SH3PXD1A}, CCN2 (cellular communication network factor 2) [NCBI Gene 1490] {aka CTGF, HCS24, IBP-8, IGFBP8, KMD, NOV2}, NOXO1 (NADPH oxidase organizer 1) [NCBI Gene 124056] {aka P41NOX, P41NOXA, P41NOXB, P41NOXC, SH3PXD5, SNX28}, EDN1 (endothelin 1) [NCBI Gene 1906] {aka ARCND3, ET1, HDLCQ7, PPET1, QME}, MAPK8 (mitogen-activated protein kinase 8) [NCBI Gene 5599] {aka JNK, JNK-46, JNK1, JNK1A2, JNK21B1/2, PRKM8}, REN (renin) [NCBI Gene 5972] {aka ADTKD4, HNFJ2, RTD}, NOX5 (NADPH oxidase 5) [NCBI Gene 79400], PRKAA2 (protein kinase AMP-activated catalytic subunit alpha 2) [NCBI Gene 5563] {aka AMPK, AMPK2, AMPKa2, PRKAA}, NOX4 (NADPH oxidase 4) [NCBI Gene 50507] {aka KOX, KOX-1, RENOX}, Mcat (malonyl CoA:ACP acyltransferase (mitochondrial)) [NCBI Gene 223722], NCF4 (neutrophil cytosolic factor 4) [NCBI Gene 4689] {aka CGD3, NCF, P40PHOX, SH3PXD4}, DUOX1 (dual oxidase 1) [NCBI Gene 53905] {aka LNOX1, NOXEF1, THOX1}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, CYBA (cytochrome b-245 alpha chain) [NCBI Gene 1535] {aka CGD4, p22-PHOX}, NOX1 (NADPH oxidase 1) [NCBI Gene 27035] {aka GP91-2, MOX1, NOH-1, NOH-1L, NOH1}, MAPK14 (mitogen-activated protein kinase 14) [NCBI Gene 1432] {aka CSBP, CSBP1, CSBP2, CSPB1, EXIP, Mxi2}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, Nos1 (nitric oxide synthase 1, neuronal) [NCBI Gene 18125] {aka 2310005C01Rik, N-NOS, NC-NOS, NO, NOS, NOS-I}, Xdh (xanthine dehydrogenase) [NCBI Gene 22436] {aka XO, Xor, Xox-1, Xox1}, CYP4F3 (cytochrome P450 family 4 subfamily F member 3) [NCBI Gene 4051] {aka CPF3, CYP4F, CYPIVF3, LTB4H}, RAC1 (Rac family small GTPase 1) [NCBI Gene 5879] {aka MIG5, MRD48, Rac-1, TC-25, p21-Rac1}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, DUOX2 (dual oxidase 2) [NCBI Gene 50506] {aka LNOX2, NOXEF2, P138-TOX, TDH6, THOX2}, AGT (angiotensinogen) [NCBI Gene 183] {aka ANHU, SERPINA8, hFLT1}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, GSR (glutathione-disulfide reductase) [NCBI Gene 2936] {aka CNSHA10, GR, GSRD, HEL-75, HEL-S-122m}, NOS2 (nitric oxide synthase 2) [NCBI Gene 4843] {aka HEP-NOS, INOS, NOS, NOS2A}, NOXA1 (NADPH oxidase activator 1) [NCBI Gene 10811] {aka NY-CO-31, SDCCAG31, p51NOX}, KEAP1 (kelch like ECH associated protein 1) [NCBI Gene 9817] {aka INrf2, KLHL19}
- **Diseases:** energy deficiency (MESH:D011502), ischemic damage (MESH:D017202), ischemia/reperfusion injury (MESH:D015427), hypoxia (MESH:D000860), myocardial alterations (MESH:D004408), heart failure (MESH:D006333), cardiomyocyte hypertrophy (MESH:D006984), atherosclerosis (MESH:D050197), insulin resistance (MESH:D007333), endothelial dysfunction (MESH:D014652), ischemic myocardium (MESH:D017682), coronary atherosclerosis (MESH:D003324), ischemic (MESH:D002545), cardiac inflammation (MESH:D007249), cardiac alterations (MESH:D006338), III, IV, and (MESH:D006011), diabetes (MESH:D003920), ultrastructure abnormalities (MESH:D000014), cardiac hypertrophy (MESH:D006332), hypertension (MESH:D006973), structure and function (MESH:D020914), CVD (MESH:D002318), Cytotoxicity (MESH:D064420), hypercholesterolemia (MESH:D006937), mitochondrial complex I (MESH:C537475), acidosis (MESH:D000138), left ventricular hypertrophy (MESH:D017379), Mitochondrial mutagenesis (MESH:D028361), Cardiac Aging (MESH:D006331), systemic arterial hypertension (MESH:D000081029), fibrosis (MESH:D005355), ischemia (MESH:D007511), LV dyssynchrony (MESH:D018487), hyperglycemia (MESH:D006943), concentric remodeling (MESH:C567712), cardiac damage and remodeling (MESH:D020257)
- **Chemicals:** glycogen (MESH:D006003), heme (MESH:D006418), amino acids (MESH:D000596), calcium (MESH:D002118), NO (MESH:D009569), acetyl-L-carnitine (MESH:D000108), glutathione (MESH:D005978), creatine phosphate (MESH:D010725), Vitamin C (MESH:D001205), ketone (MESH:D007659), peroxides (MESH:D010545), ROS (MESH:D017382), thiol (MESH:D013438), lipid (MESH:D008055), free radicals (MESH:D005609), NADH (MESH:D009243), peroxynitrite (MESH:D030421), L-citrulline (MESH:D002956), Disulfide (MESH:D004220), phospholipid (MESH:D010743), Oxygen (MESH:D010100), fatty acid (MESH:D005227), Vitamin E (MESH:D014810), cysteine (MESH:D003545), glutathione disulfide (MESH:D019803), Glucose (MESH:D005947), ketone bodies (MESH:D007657), water (MESH:D014867), hydrogen (MESH:D006859), Cardiolipin (MESH:D002308), H2O2 (MESH:D006861), lactate (MESH:D019344), superoxide (MESH:D013481), ATP (MESH:D000255), ubiquinol (MESH:C003741), heavy metals (MESH:D019216), polyphenols (MESH:D059808), carbohydrates (MESH:D002241), triglycerides (MESH:D014280), L-arginine (MESH:D001120), hydroxyl radical (MESH:D017665), O2 (-), NADPH (MESH:D009249)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Rattus norvegicus (brown rat, species) [taxon 10116], Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC8868312/full.md

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Source: https://tomesphere.com/paper/PMC8868312