Impaired functional performance despite hypertrophic enlargement, and an ex
cessive accumulation of extracellular matrix, are hallmarks of the decompen
sated failing heart. Age is the leading risk factor for heart failure, and
there is evidence suggesting that a number of age-associated changes in the
cardiac phenotype predispose the heart to failure. The spontaneously hyper
tensive rat (SHR) exhibits compensated cardiac hypertrophy followed by a tr
ansition to heart failure in the last quartile of the lifespan, and thus pr
ovides a useful model of the transition from stable compensated hypertrophy
to decompensated heart failure in the context of aging. The transition to
failure in the SHR is accompanied by marked changes in the expression of an
array of genes in the heart, including increased expression of a number of
genes associated with the extracellular matrix. Drug treatments that preve
nt or reverse matrix gene expression in the SHR heart improve myocardial fu
nction and survival. The aged SHR model of decompensated heart failure has
provided insight into the role of the extracellular matrix in the transitio
n to failure, and can be useful to further investigate the mechanistic base
s of heart failure, as well as to evaluate the potential efficacy of novel
therapeutic approaches to the treatment of heart failure. (C) 2000 Publishe
d by Elsevier Science B.V. All rights reserved.