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Cardiac aging manifests as increased left ventricular thickness, enlarged chamber size, increased fibrosis and diastolic dysfunction (7,28,29). In the present study, aging induced cardiac remodeling, including myocyte hypertrophy, interstitial fibrosis and subsequent diastolic dysfunction, as characterized by decreased FS and increased IVS-d and LVPW-d. These data suggested that the aging rat model was sufficient to investigate the potential mechanisms underlying the role of MR in age-related cardiac dysfunction.

Related articles: "hearts"

The activation of local RAAS components has been demonstrated in various tissues. Intrarenal RAAS activation is associated with the renal aging process (30,31). Enhanced vascular RAAS activation is associated with arterial aging (32) and age-related cardiac remodeling involves myocyte RAAS activation (33). MR signaling is a terminal effector in RAAS, and exerts more cardiac actions than aldosterone, due to the absence of 11β hydroxysteroid dehydrogenase type 2 (HSD2) in the heart, making cortisol (or corticosterone in rodents) the predominant ligand for MR (34). Previous research has indicated that the conditional cardiac-specific overexpression of human MR in mice generates a high rate of arrhythmia-related sudden death (35). Cardiomyocyte-specific MR deficiency improves infarct healing, and prevents progressive adverse cardiac remodeling (9) and deoxycorticosterone/salt-induced tissue inflammation and remodeling by blocking the recruitment of macrophages to the myocardium (3). Loss of cardiomyocytes-derived MR protects the transaortic constriction model from cardiac dilatation and failure; however, MR knockout does not prevent the development of cardiac remodeling and an inflammatory response after pressure overload (4). In the present study, the protein and mRNA expression levels of MR in the aging model of fibrosis were approximately two-fold higher than those in younger rats, indicating that the increased expression of MR in myocytes of aging hearts may exacerbate cardiac remodeling and cardiac dysfunction. MR expression in adult rat hearts (12-month-old) rose moderately (data not shown), suggesting that cardiomyocyte MR may serve a universal role during the whole aging process. However, whether MR accumulation in hearts is elevated in healthy older humans and its potential clinical implications remain to be investigated.

The increase in MR activation may be a key pathogenic factor that links aging-related mitochondrial dysfunction to cardiac aging in rats. In addition, the results of the present study indicated that the increase in age-associated MR expression may lead to mitochondrial dysfunction, increased oxidative stress and cardiac remodeling via an imbalance in the p53/PGC-1α axis. Further studies are required to clarify the interaction between MR and age-related mitochondrial dysfunction, and to clarify whether the antagonism of MR in hearts can delay the progression of cardiac aging and prolong lifespan.

This publication seeks to contribute to meeting these recommendations by providing a practical tool for governments to improve their national regulatory frameworks to improve accuracy of blood pressure measuring devices (BPMDs), in turn contributing to the exclusive use of accuracy validated automated BPMDs in primary health care (PHC) facilities by 2025. This publication can also guide the development of procurement mechanisms that will ensure exclusive availability of BPMDs in PHC facilities. Specifically, this publication will provide a brief background on the importance of using validated BPMDs and highlight key elements of regulations related to pre-market approvals to promote accurate BPMDs.

What now is known as the Purple Heart began as the Badge of Military Merit, established by George Washington on August 7, 1782. At that time, and for many decades afterwards, there were very few awards that common soldiers could receive in service of their country. Most awards, decorations, and medals were given to great commanders, aristocrats, or kings. Recognizing that the Continental Army was fighting a tough campaign, supplies were scarce, and pay was low, Washington felt a need to encourage his troops by establishing an award for valor and meritorious service. This established a precedent within awards systems for valor, defined as heroic actions in combat, and merit, which is proper performance of military duties not related to combat. Washington presented the Badge of Military Merit, which consisted of a cloth purple heart to be worn over the left breast, to three sergeants in his army.

Thank you to all the participants in Round 2 for leaving behind pieces of yourselves in your comments. The Global Youth team enjoyed getting lost in your stories. The most successful storytellers were those who knitted together tales of their personal experiences with direct references to the related article, while not losing the connection to their fundamental message. In other words, their comments expressed storytelling with a purpose. We also honored authenticity. We were put off by narratives that felt contrived or rambled on too long. 041b061a72


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