Mechanisms contributing to myocardial potassium channel diversity, regulation and remodeling

In the mammalian heart, multiple types of K⁺ channels contribute to the control of cardiac electrical and mechanical functioning through the regulation of resting membrane potentials, action potential waveforms and refractoriness. There are similarly vast arrays of K⁺ channel pore-forming and accessory subunits that contribute to the generation of functional myocardial K⁺ channel diversity. Maladaptive remodeling of K⁺ channels associated with cardiac and systemic diseases results in impaired repolarization and increased propensity for arrhythmias. Here, we review the diverse transcriptional, post-transcriptional, post-translational, and epigenetic mechanisms contributing to regulating the expression, distribution, and remodeling of cardiac K⁺ channels under physiological and pathological conditions.