Worldwide increase in life expectancy is a major contributor to the epidemic of chronic degenerative diseases. Aging, indeed, simultaneously affects multiple organ systems, and it has been hypothesized that systemic alterations in regulators of tissue physiology may regulate this process. Cardiac aging itself is a major risk factor for cardiovascular diseases and, because of the intimate relationship with the brain, may contribute to increase the risk of neurodegenerative disorders. Blood-borne factors may play a major role in this complex and still elusive process. A number of studies, mainly based on the revival of parabiosis, a surgical technique very popular during the 70s of the 20 th century to study the effect of a shared circulation in two animals, have indeed shown the potential that humoral factors can control the aging process in different tissues. In this article we review the role of circulating factors in cardiovascular aging. A better understanding of these mechanisms may provide new insights in the aging process and provide novel therapeutic opportunities for chronic age-related disorders.

Acute upside down reversal of vision in vertebrobasilar ischaemiaAcute upside down reversal of vision is an uncommon and little known phenomenon consisting of transient complete 180 degree inversion of the visual image. The pathogenesis and the anatomical sites of this dysfunction are unknown. Lesions involving cortical areas, mainly the parieto-occipital region, or the vestibulocerebellar system have occasionally been documented. -5 We observed two patients who experienced this bizarre visual illusion, both revealing features of vertebrobasilar ischaemia.Patient 1, a 69 year old woman, was admitted because two weeks earlier she had experienced sudden malaise, sweating, nausea, vomiting, right occipital headache, followed by a 180 degree vertical inversion of the visual image, lasting about 20 minutes. Two similar episodes had occurred the day before admission. On admission the patient was alert, cooperative and well-oriented. The neurological examination was normal. In particular, no neurophthalmological abnormalities were found on clinical examination. Blood parameters, urine, chest radiograph and ECG proved normal. Cervical radiographs revealed osteoarthritis with osteophytes and narrowing of disc space C6-C7. EEG was normal. Brainstem auditory evoked potentials (BAER) revealed increased latency of V wave on right stimulation. Cerebral CT and MRI (figure) showed an ischaemic-like lesion, 2 cm diameter, in the right cerebellar hemisphere in the territory of the medial branch of the posterior inferior cerebellar artery (PICA)

Background Population aging has increased together with the need for cardiovascular care. Understanding the relevance of cardiovascular conditions in the very old is crucial to developing a specific and rationale therapeutic approach. Centenarians can be considered a model of successful aging, although the impact of cardiovascular disease in this population is still unclear.Aim To evaluate the cardiovascular health status of a subset of centenarians enrolled in the Centenari a Trieste study and living in the province of Trieste to describe the prevalence of cardiovascular conditions among them.Methods The current study included 20 individuals born before 1919 and living in the province of Trieste as of 1 May 2019. All centenarians were able to give consent and were subjected to an in-home complete clinical assessment focused on cardiovascular conditions, ECG and echocardiography. ResultsThe majority of centenarians were women (85%) and were not taking any chronic cardiovascular medication (55%). No centenarians had a history of ischemic heart disease while about one-third had signs suggestive of heart failure at examination (20%). Atrial fibrillation was present in 20% of individuals and conduction disorders were uncommon. Although the majority of individuals had a preserved left ventricular function, diastolic function was abnormal in 80% of enrolled centenarians that, however, was mild in 73% of cases.Conclusion This is the second study to perform in-home echocardiography in centenarians and the first to characterize the cardiovascular status of centenarians living in Trieste. The majority of centenarians had asymptomatic diastolic dysfunction and were naı ¨ve from cardiovascular therapy. The recruitment of new individuals from the Trieste area is continuing to perform analyses on clinical, genetic and environmental factors that may predict greater longevity in this geographical context and unveil mechanisms that regulate cardiac aging associated with increased lifespan.

No abstract

No abstract