title: Cardiac-specific ablation of the Na+-Ca2+ exchanger confers protection against ischemia/reperfusion injury.
abstract: During ischemia and reperfusion, with an increase in intracellular Na+ and a depolarized membrane potential, Ca2+ may enter the myocyte in exchange for intracellular Na+ via reverse-mode Na+-Ca2+ exchange (NCX). To test the role of Ca2+ entry via NCX during ischemia and reperfusion, we studied mice with cardiac-specific ablation of NCX (NCX-KO) and demonstrated that reverse-mode Ca2+ influx is absent in the NCX-KO myocytes. Langendorff perfused hearts were subjected to 20 minutes of global ischemia followed by 2 hours of reperfusion, during which time we monitored high-energy phosphates using 31P-NMR and left-ventricular developed pressure. In another group of hearts, we monitored intracellular Na+ using 23Na-NMR. Consistent with Ca2+ entry via NCX during ischemia, we found that hearts lacking NCX exhibited less of a decline in ATP during ischemia, delayed ischemic contracture, and reduced maximum contracture. Furthermore, on reperfusion following ischemia, NCX-KO hearts had much less necrosis, better recovery of left-ventricular developed pressure, improved phosphocreatine recovery, and reduced Na+ overload. The improved recovery of function following ischemia in NCX-KO hearts was not attributable to the reduced preischemic contractility in NCX-KO hearts, because when the preischemic workload was matched by treatment with isoproterenol, NCX-KO hearts still exhibited improved postischemic function compared with wild-type hearts. Thus, NCX-KO hearts were significantly protected against ischemia-reperfusion injury, suggesting that Ca2+ entry via reverse-mode NCX is a major cause of ischemia/reperfusion injury.
authors.affiliation: Laboratory of Signal Transduction, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Imahashi
authors.forename: Christian
authors.initials: C
authors.lastname: Pott
authors.forename: Joshua I
authors.initials: JI
authors.lastname: Goldhaber
authors.forename: Charles
authors.initials: C
authors.lastname: Steenbergen
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Philipson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Murphy
mesh_terms: D000818:Animals; D002118:Calcium / Q000378:metabolism; D004734:Energy Metabolism; D007545:Isoproterenol / Q000494:pharmacology; D051379:Mice; D018345:Mice, Knockout; D009200:Myocardial Contraction; D015428:Myocardial Reperfusion Injury / Q000209:etiology* / Q000517:prevention & control; D009206:Myocardium / Q000378:metabolism*; D010641:Phenotype; D012964:Sodium / Q000378:metabolism; D019831:Sodium-Calcium Exchanger / Q000037:antagonists & inhibitors / Q000502:physiology*
chemical_list: D019831:Sodium-Calcium Exchanger; D012964:Sodium; D007545:Isoproterenol; D002118:Calcium