Diabetes Mellitus and Ischemic Heart Disease: The Role of Ion Channels

Severino, Paolo; D’Amato, Andrea; Netti, Lucrezia; Pucci, Mariateresa; Marchis, Marialaura De; Palmirotta, Raffaele; Volterrani, Maurizio; Mancone, Massimo; Fedele, Francesco

doi:10.3390/ijms19030802

Cited by 53 publications

(100 citation statements)

References 122 publications

(194 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, it is important to decipher pathophysiological mechanisms that underlie the heart damage [69][70][71]; also, it is fundamental to identify any involvement of systemic organs [72][73][74][75]. In the management of patients with HF, instead of utilizing the new ESC classification of preserved, mid-range, and reduced LVEF to identify HF patients, we propose an alternate approach by HLM classification and multimodality imaging.…”

Section: Heart Failure Classification Beyond Ejection Fractionmentioning

confidence: 99%

Structural and myocardial dysfunction in heart failure beyond ejection fraction

et al. 2019

Self Cite

View full text Add to dashboard Cite

Heart failure is a multifaceted syndrome addressing for a high rate of death among the general population. The common approach to this disease has been always based on the evaluation of the left ventricular ejection fraction by two-dimensional echocardiography with Simpson's method. Mounting evidences have demonstrated the pitfalls of this method and have suggested that the management of heart failure requires a deep knowledge of the pathophysiological insights of the disease and cannot rely only on the evaluation of the left ventricular ejection fraction. Several advanced imaging technologies overwhelm the evaluation of ejection fraction and could provide a better understanding of the myocardial abnormalities underlying heart failure. Considering the limitation of left ventricular ejection fraction and the systemic involvement of heart failure, classifications of heart failure based on ejection fraction should be substituted with a comprehensive "staging" of multiorgan damage, not only considering the heart but also the lungs, kidneys, and liver, such as the HLM staging system. Such a holistic approach based on the HLM staging system and multimodality imaging can provide a global assessment of patient features allowing for targeted therapies and better heart failure management.

show abstract

Section: Heart Failure Classification Beyond Ejection Fractionmentioning

confidence: 99%

Structural and myocardial dysfunction in heart failure beyond ejection fraction

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Nonetheless, our understanding is lacking about the regional heterogeneity in the nature and composition of K + channels in different vascular beds. Moreover, given strong evidence of the critical role of K + channels in a variety of vascular pathological conditions including hypertension, PA hypertension, atherosclerosis, and diabetes mellitus, targeting K + channel function represents a novel and promising strategy for the prevention and treatment of a variety of diseases . However, many complex alterations in vascular K + channel functions have been described in diseases, and the understanding of the regulation of expression and function of the K + channels in these disease states is also limited, especially since these diseases relate to different vascular beds throughout the body.…”

Section: Discussionmentioning

confidence: 99%

Potassium channels in vascular smooth muscle: a pathophysiological and pharmacological perspective

Doğan

Yıldız

Arslan

et al. 2019

Fundamemntal Clinical Pharma

View full text Add to dashboard Cite

Potassium (K+) ion channel activity is an important determinant of vascular tone by regulating cell membrane potential (MP). Activation of K+ channels leads to membrane hyperpolarization and subsequently vasodilatation, while inhibition of the channels causes membrane depolarization and then vasoconstriction. So far five distinct types of K+ channels have been identified in vascular smooth muscle cells (VSMCs): Ca+2‐activated K+ channels (BKCa), voltage‐dependent K+ channels (KV), ATP‐sensitive K+ channels (KATP), inward rectifier K+ channels (Kir), and tandem two‐pore K+ channels (K2P). The activity and expression of vascular K+ channels are changed during major vascular diseases such as hypertension, pulmonary hypertension, hypercholesterolemia, atherosclerosis, and diabetes mellitus. The defective function of K+ channels is commonly associated with impaired vascular responses and is likely to become as a result of changes in K+ channels during vascular diseases. Increased K+ channel function and expression may also help to compensate for increased abnormal vascular tone. There are many pharmacological and genotypic studies which were carried out on the subtypes of K+ channels expressed in variable amounts in different vascular beds. Modulation of K+ channel activity by molecular approaches and selective drug development may be a novel treatment modality for vascular dysfunction in the future. This review presents the basic properties, physiological functions, pathophysiological, and pharmacological roles of the five major classes of K+ channels that have been determined in VSMCs.

show abstract

“…HF mortality is increasing despite an overall decline in cardiovascular deaths due to improved survival of patients with diseases leading to HF. Improvements in assessment and management, along with an emphasis on prevention, has impacted greatly on survival from ischemic heart disease and has reduced the co-morbidities triggered by hypertension and diabetes mellitus [20][21][22][23]. These patients are living longer, but ongoing cardiac remodeling is creating a new generation of HF patients.…”

Section: Adhf and End-stage Hf: Difference In Clinical And Functionalmentioning

confidence: 99%

Advanced Heart Failure and End-Stage Heart Failure: Does a Difference Exist

et al. 2019

View full text Add to dashboard Cite

Advanced heart failure (AdHF) represents a challenging aspect of heart failure patients. Because of worsening clinical symptoms, high rates of re-hospitalization and mortality, AdHF represents an unstable condition where standard treatments are inadequate and additional interventions must be applied. A heart transplant is considered the optimal therapy for AdHF, but the great problem linked to the scarcity of organs and long waiting lists have led to the use of mechanical circulatory support with ventricular-assist device (VAD) as a destination therapy. VAD placement improves the prognosis, functional status, and quality of life of AdHF patients, with high rates of survival at 1 year, similar to transplant. However, the key element is to select the right patient at the right moment. The complete assessment must include a careful clinical evaluation, but also take into account psychosocial factors that are of crucial importance in the out-of-hospital management. It is important to distinguish between AdHF and end-stage HF, for which advanced therapy interventions would be unreasonable due to severe and irreversible organ damage and, instead, palliative care should be preferred to improve quality of life and relief of suffering. The correct selection of patients represents a great issue to solve, both ethically and economically.

show abstract

Diabetes Mellitus and Ischemic Heart Disease: The Role of Ion Channels

Cited by 53 publications

References 122 publications

Structural and myocardial dysfunction in heart failure beyond ejection fraction

Structural and myocardial dysfunction in heart failure beyond ejection fraction

Potassium channels in vascular smooth muscle: a pathophysiological and pharmacological perspective

Advanced Heart Failure and End-Stage Heart Failure: Does a Difference Exist

Contact Info

Product

Resources

About