Dysregulation of key transporters—such as the MCU complex, VDAC isoforms, TRP channels, ANT and SLC25 family members (e.g., SLC25A1 and SLC25A20)—drives bioenergetic failure, oxidative stress, apoptotic signaling, and maladaptive remodeling across CVD spectra, from heart failure and ischemic injury to atherosclerosis and cardiomyopathies. Here, SLC25A20 is linked to atherosclerosis.