Despite painstaking investigations on the pathogenetic mechanisms of heart failure, there still remains a long distance to completely understand the complexity of the events dominating its progression. In this direction, many efforts have been made by recruiting both basic physiology and imaging techniques in order to overcome gaps that are present in diagnostic and therapeutical interventions in heart failure. Intact heart muscle physiology and circulation are the cornerstone for a comprehensive insight into the mechanistic understanding of the relationship between contractility, coronary blood flow, and myocardial perfusion. The latter seems to be a major cause of cardiac muscle damage leading to progression into systolic heart failure. Therefore, it is a matter of urgency to re-evaluate and extend the spectrum of imaging techniques for achieving a better assessment of myocardial perfusion based on fundamental concepts of cardiac cellular and subcellular physiology.
Keywords: Actin, Calcium kinetics, Cardiac physiology, Diastolic dysfunction, Endothelin, Excitation-contraction coupling, Myocardial contractility, Myocardial perfusion, Myosin, Phospholamban, Relaxation, Ryanodine receptor, Tropomyosin, Troponin.