fig2

Figure 2. Similar fundamental biology underlying aging and heart failure. The antagonistic pleiotropy theory of aging proposes that evolution strongly selects for traits that maximize early-life survival, growth, and reproduction. However, these same traits can be deleterious in late life and lead to aging and chronic diseases, such as heart failure. Classic examples of this are senescence and IGF1 signaling, which enhance survival and growth in early life, but contribute to adverse cardiac remodeling and dysfunction in late life. The modified disposable soma theory of aging proposes that in early life, organisms will prioritize resources for biological processes that maximize early mid-life survival/growth/function/reproduction (at the expense of maintaining the soma), ultimately leading to accumulating DNA damage and aging. In later life, organisms shift priorities and resource utilization to maintain the soma, even at the expense of function. However, chronic activation of these survival pathways (e.g., senescence, Akt signaling) can become maladaptive, contributing to further adverse remodeling and functional decline in the aging heart. This illustration was partly generated using images adapted from BioRender and Servier Medical Art (https://smart.servier.com). Servier Medical Art is provided by Servier, licensed under a Creative Commons Attribution 4.0 license (https://creativecommons.org/licenses/by/4.0/).