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. Author manuscript; available in PMC: 2013 Jan 1.
Published in final edited form as: Heart Fail Clin. 2012 Jan;8(1):143–164. doi: 10.1016/j.hfc.2011.08.011

FIGURE 11.

FIGURE 11

Changes in the injury and protection thresholds in aging heart. (A) Aging diminishes the hearts threshold to sustain injury (e.g., from ischemia/reperfusion, etc.). Lifestyle modifications, including exercise and possibly caloric restriction, may partially diminish the aging effect. Comorbidities (such as diabetes) have negative influence. (B) Aging increases the hearts threshold to activate protection-signaling mechanisms. Various pharmacologic agents (e.g., sulfonylureas, antioxidants, partial fatty acid oxidation (PFAO) inhibitors, and COX-2 inhibitors) that can interfere with cardioprotective signaling-pathways can exacerbate this trend and further increase the protection threshold. Exercise and caloric restriction might attenuate the age-dependent trends (Modified from Juhaszova M, Rabuel C, Zorov DB, et al: 2005. Protection in the aged heart: preventing the heart-break of old age? Cardiovasc Res 66: 233–244).