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

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

doi:10.3390/ijms19030802

Abstract

Diabetes mellitus is one the strongest risk factors for cardiovascular disease and, in particular, for ischemic heart disease (IHD). The pathophysiology of myocardial ischemia in diabetic patients is complex and not fully understood: some diabetic patients have mainly coronary stenosis obstructing blood flow to the myocardium; others present with coronary microvascular disease with an absence of plaques in the epicardial vessels. Ion channels acting in the cross-talk between the myocardial energy state and coronary blood flow may play a role in the pathophysiology of IHD in diabetic patients. In particular, some genetic variants for ATP-dependent potassium channels seem to be involved in the determinism of IHD.

Highlights

Diabetes mellitus (DM) is a complex and heterogeneous chronic metabolic disease caused by elevated levels of blood glucose
ischemic heart disease (IHD) is the expression of coronary artery disease (CAD); clinical, angiographic, and autoptic findings show that coronary microvascular dysfunction, impairing vasomotor tone, is able to provoke IHD independently from the presence of an atherosclerotic stenosis
An increasing number of studies have shown the importance of ion channels as end effectors of several regulation mechanisms, such as coronary blood flow and glucose homeostasis

Summary

Introduction

Diabetes mellitus (DM) is a complex and heterogeneous chronic metabolic disease caused by elevated levels of blood glucose. DM has a great impact worldwide: the prevalence is more than 350 million people, with 52 million in Europe. Those numbers refer to 2011 and will probably increase in the decades. Type 1 DM (T1DM) is due to T-cell–mediated autoimmune destruction of pancreatic β-cells that leads to insulin deficiency [1]; T1DM occurs mostly in young people, generally up to 30 years of age. Type 2 DM (T2DM) is characterized by both insulin resistance and failure of pancreatic β-cells. Other specific types of DM are due to either single genetic mutations, to other pathological diseases of the pancreas, or to drugs.

Coronary Blood Flow Regulation

Role of Ion Channels in Coronary Blood Flow Regulation

Findings

Conclusions