Exercise for Cardiovascular Disease Prevention and Treatment From Molecular to Clinical, Part 1

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© Springer Nature Singapore Pte Ltd. 2017 231
J. Xiao (ed.), Exercise for Cardiovascular Disease Prevention and Treatment,
Advances in Experimental Medicine and Biology 999,
DOI 10.1007/978-981-10-4307-9_13


Chapter 13


Cardiac Aging – Benefits of Exercise, Nrf2


Activation and Antioxidant Signaling


Madhusudhanan Narasimhan and Namakkal-Soorappan Rajasekaran


Abstract Cardiovascular dysfunction and heart failure associated with aging not


only impairs the cardiac function but also the quality of life eventually decreasing


the life expectancy of the elderly. Notably, cardiac tissue can prematurely age under


certain conditions such as genetic mutation, persistent redox stress and overload,


aberrant molecular signaling, DNA damage, telomere attrition, and other pathologi-


cal insults. While cardiovascular-related morbidity and mortality is on the rise and


remains a global health threat, there has been only little to moderate improvements


in its medical management. This is due to the fact that the lifestyle changes to


molecular mechanisms underlying age-related myocardial structure and functional


remodeling are multifactorial and intricately operate at different levels. Along these


lines, the intrinsic redox mechanisms and oxidative stress (OS) are widely studied


in the myocardium. The accumulation of reactive oxygen species (ROS) with age


and the resultant oxidative damage has been shown to increase the susceptibility of


the myocardium to multiple complications such as atherosclerosis, hypertension,


ischemic heart disease, cardiac myopathy, and heart failure. There has been growing


interest in trying to enhance the mechanisms that neutralize the ROS and curtailing


OS as a possible anti-aging intervention and as a treatment for age-related disorders.


Natural defense system to fight against OS involves a master transcription factor


named nuclear erythroid-2-p45-related factor-2 (Nrf2) that regulates several anti-


oxidant genes. Compelling evidence exists on the Nrf2 gain of function through


pharmacological interventions in counteracting the oxidative damage and affords


cytoprotection in several organs including but not limited to lung, liver, kidney,


M. Narasimhan (*)
Department of Pharmacology and Neuroscience, Texas Tech University Health
Sciences Center, Lubbock, TX 79430, USA
e-mail: [email protected]


N.-S. Rajasekaran (*)
Division of Molecular & Cellular Pathology, Department of Pathology,
University of Alabama at Birmingham, Birmingham, AL 35294, USA


Departments of Medicine & Exercise Physiology, College of Health,
University of Utah School of Medicine, Salt Lake City, UT 84132, USA
e-mail: [email protected]; [email protected]

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