Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161 Rome, Italy.
Int J Mol Sci. 2020 Apr 30;21(9):3167. doi: 10.3390/ijms21093167.
Heart failure is a complex syndrome responsible for high rates of death and hospitalization. Ischemic heart disease is one of the most frequent causes of heart failure and it is normally attributed to coronary artery disease, defined by the presence of one or more obstructive plaques, which determine a reduced coronary blood flow, causing myocardial ischemia and consequent heart failure. However, coronary obstruction is only an element of a complex pathophysiological process that leads to myocardial ischemia. In the literature, attention paid to the role of microcirculation, in the pathophysiology of ischemic heart disease and heart failure, is growing. Coronary microvascular dysfunction determines an inability of coronary circulation to satisfy myocardial metabolic demands, due to the imbalance of coronary blood flow regulatory mechanisms, including ion channels, leading to the development of hypoxia, fibrosis and tissue death, which may determine a loss of myocardial function, even beyond the presence of atherosclerotic epicardial plaques. For this reason, ion channels may represent the link among coronary microvascular dysfunction, ischemic heart disease and consequent heart failure.
心力衰竭是一种导致高死亡率和高住院率的复杂综合征。缺血性心脏病是心力衰竭最常见的原因之一，通常归因于冠状动脉疾病，其特征是存在一个或多个阻塞性斑块，这会导致冠状动脉血流减少，引起心肌缺血和随后的心力衰竭。然而，冠状动脉阻塞只是导致心肌缺血的复杂病理生理过程的一个因素。在文献中，人们越来越关注微循环在缺血性心脏病和心力衰竭病理生理学中的作用。冠状动脉微血管功能障碍导致冠状动脉循环无法满足心肌代谢需求，这是由于包括离子通道在内的冠状动脉血流调节机制失衡所致，导致缺氧、纤维化和组织死亡，这可能导致心肌功能丧失，即使在存在动脉粥样硬化心外膜斑块的情况下也是如此。因此，离子通道可能是冠状动脉微血管功能障碍、缺血性心脏病和随后的心力衰竭之间的联系。
