© 2003 by European Society of Cardiology
Copyright © 2003, European Society of Cardiology
Relevance of Na+–Ca2+ exchange in heart failure
aHerzzentrum Göttingen, Kardiologie und Pneumologie, Georg-August-Universität Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
bExperimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam and the Interuniversity Cardiology Institute of the Netherlands, Amsterdam, The Netherlands
* Corresponding author. Tel.: +49-551-39-6351; fax: +49-551-39-6389. hasenfus@med.uni-goettingen.de
Received 23 September 2002; accepted 27 November 2002
KEYWORDS Arrhythmia (mechanisms); Contractile function; Heart failure; Na/Ca-exchanger; Sarcolemma
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1. Introduction |
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Sarcolemmal Na+–Ca2+ exchange plays a pivotal role in ion transport of the myocardium which is crucial for cardiac contractile performance. The driving force of the exchanger molecule depends on sodium and calcium concentrations at either side of the plasma membrane and on the membrane potential. Section 2 of this article aims to review structural and thermodynamic aspects of the Na+–Ca2+ exchanger and its function. Recently, it has been recognized that Ca2+ as well as Na+ homeostasis is impaired in the failing myocardium. Thus, it has been postulated by numerous authors that Na+–Ca2+ exchanger may be altered with respect to expression and function. However, the literature is controversial. Section 3 comments upon a number of recent publications that have been published on this topic. Section 4 summarizes functional consequences of altered expression and function of the exchanger with respect to excitation–contraction coupling which have to be considered with
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2. Molecular physiology of Na+–Ca2+ exchange |
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2.1 Isoforms, expression, structure and regulation
2.2 Thermodynamics, flux and beat to beat activity
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3. NCX expression and function in hypertrophy and failure |
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4. NCX and excitation–contraction coupling in heart failure |
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5. NCX and arrhythmias in heart failure |
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6. Summary |
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