UDC

611-018.2:616.127-005.8-002.17-06:612.67

Authors

Anna N. Putyatina*, Lena B. Kim*
*Research Institute of Experimental and Clinical Medicine (Novosibirsk, Russian Federation)

Abstract

Modern cardiology has made great progress in the diagnosis of myocardial infarction, high-tech treatment of patients, and development of new groups of drugs for earliest possible recovery of blood supply to the ischemic myocardium. However, there remains a serious concern about mortality due to myocardial infarction, especially in older adults. To improve the situation, it is important to study the mechanisms of age-related changes in the reactivity of cardiac extracellular matrix and in the metabolism of its components. This can broaden our understanding of the nature and intensity of cardiac remodelling. The functionality of cells producing extracellular matrix proteins in response to exogenous and endogenous factors decreases with age. The quantitative and qualitative composition of cardiac extracellular matrix components also undergoes changes: collagen and fibronectin content increases, while the content of proteoglycans/glycosaminoglycans and matricellular proteins decreases, which is caused by the changing balance in the local regulation system (matrix metalloproteinases/tissue inhibitors of matrix metalloproteinases) and promotes cardiac interstitial fibrosis. Reparative myocardial fibrosis has been demonstrated to have different intensity depending on age and comorbidities. Modern clinical methods of functional assessment of cardiac remodelling in infarction only show changes in heart structural and functional characteristics and provide little information on the mechanisms of reparative fibrosis. The following phases can be distinguished in reparative fibrosis progression: the phase of destructive processes in the extracellular matrix, the phase of peak synthesis of extracellular matrix proteins, and the reduced synthesis phase. It should be noted that age-dependent modification of reparative fibrosis often causes the complications of myocardial infarction.

Keywords

extracellular matrix, collagens, proteoglycans, fibronectin, reparative fibrosis, ageing, myocardial infarction

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