Researchers here provide evidence to show that measures of skin aging sensitive to the progression of fibrosis appear to correlate with the risk of suffering conductive disorders of cardiac tissue. The heart is an electrochemical machine, and electrical properties of heart tissue such as the atrioventricular node are vital to the way in which the organ functions. Fibrosis in heart tissue disrupts these electrical properties, just as it disrupts any function of tissue that depends on its fine structure.
Fibrosis is the creation of scar-like deposits in place of normal tissue structure, the result of an age-related disruption of normal regenerative and tissue maintenance processes. It is thought that chronic inflammation and the presence of senescent cells are among the more important causes of fibrosis, though the authors of this paper prefer to focus on cross-linking of AGEs, and these are global issues in the aging body. So while any observed correlation between aspects of aging must be eyed carefully, simply because aging is a collection of interacting processes that all happen at the same time, it is at least plausible that increased prevalence of fibrosis throughout the body is a mechanism to produce the observed results here.
Skin acts as a mirror to the internal state of the body. There are many scoring systems used in the assessment of skin aging. SCINEXA (SCore for INtrinsic and EXtrinsic skin Aging) is an easy-to-use clinical scoring system recently developed to differentiate between chronological (intrinsic) skin aging and photo (extrinsic) skin aging. However, no studies have evaluated the relationship between skin-aging parameters and the incidence of degenerative advanced-degree atrioventricular conduction disorders, or AV block. With increasing age, these disorders are inevitable. About 30% of people older than 65 years have AV conduction or intraventricular conduction defects. Pulse rate interval increases with increasing age caused by delayed conduction in the atrioventricular node (AVN) and the proximal portion of the His bundle.
Can we use skin parameters to predict the presence of heart block? Carotid atherosclerosis is related to perceived age (associated with higher degrees of facial pigmentation), and may be a better predictor of mortality than chronological age. In our study, uneven pigmentation was higher in those with advanced-degree heart block; the grades of fine skin wrinkles were significantly higher in heart block group.
Our skin becomes stiff, thin, and flabby, with the development of more wrinkles with advanced age, and all are related to fibrosis of the skin, as elastic fibers are injured and collagen fibers are broken with the passage of time. New collagen fibers are produced to replace broken elastic fibers and broken collagen fibers. Tissue fibrosis due to progressive deposition of excessive collagen fibers has been observed in most organs with aging, especially the heart. This results in hardening and atrophy of that organ, secondary to loss of parenchyma cells and the increase of collagen substance in tissues. Essential arterial hypertension, sinus node dysfunction, and degenerative AV block are examples of cardiac complications that are caused by tissue fibrosis. In our study, the grades of the lax appearance of the face and reduced fat tissue, prevalence of seborrheic keratosis, and the total score of intrinsic skin aging were significantly higher in the group of heart block.
The association between intrinsic skin aging and degenerative advanced-degree AV block could be explained by the pathogenesis background that may be incriminated in the development of both disorders. Extensive evidence, derived from both clinical and experimental studies, suggests that the aging heart undergoes fibrotic remodeling. Advanced glycation end products (AGEs), which are developed by the glycation and oxidation of different structural proteins, and play an important role in age-dependent changes, were described in skin aging and in organs such as the kidney, blood vessels, and the eye lenses. AGEs are important factors for assessing cardiac aging and fibrosis. Further, diminished expression of connective tissue growth factor (CTGF) is responsible for the progressive loss of dermal collagen. There are positive correlations between the levels of CTGF and cardiovascular fibrotic diseases in the elderly population.