Figure 2.

Mechanisms involved in ischemic heart disease pathophysiology and coronary ion channels role. Ischemic heart disease hides a multifaceted and complex pathophysiological paradigm. Several pathways are involved in the ischemic heart disease pathophysiology (i.e., micro and macrovascular dysfunction, atherosclerotic plaque rupture, inflammation, endothelium dependent and independent dysfunction, ion channels and nervous system impairment). In particular, coronary ion channels, represented in the central part of the figure, are the final effectors of coronary blood flow regulation mechanisms, playing a pivotal role in the coupling between myocardial metabolism and coronary circulation. Their activity dysregulation may occur during coronary microvascular dysfunction and other pathological conditions. It causes the impairment in the cross talk between myocardial energy state and coronary blood flow, leading to ischemic heart disease.