Copyright © 2005, European Society of Cardiology
Na+–Ca2+exchange in the regulation of cardiac excitation–contraction coupling
aLaboratory of Muscle Research and Molecular Cardiology, Department of Internal Medicine III, University of Cologne, Joseph-Stelzmann-Str. 9, 50924 Cologne, Germany
bDepartments of Medicine and Physiology David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1679, United States
cCardiovascular Research Laboratories David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1679, United States
* Corresponding author. Tel.: +49 221 478 6205; fax: +49 221 478 6550. Email address: Hannes.Reuter{at}koeln.de
Cardiac sarcolemmal Na+–Ca2+ exchange is a central component of Ca2+ signaling essential for Ca2+ extrusion and contributing to a variable degree to the development of the systolic Ca2+ transient. Reports on differential gene expression of Na+–Ca2+ exchange in cardiac disease and the regulation of its thermodynamic equilibrium depending on intracellular gradients of ion concentrations between subcellular compartments have recently put a new complexion on Na+–Ca2+ exchange and its implications for excitation–contraction (E–C) coupling. Heart failure models and genetic approaches to regulate expression of the Na+–Ca2+ exchanger have improved our knowledge of exchanger function. Modest overexpression of the Na+–Ca2+ exchanger in heterozygous transgenic mice had minimal effects on E–C coupling and cardiac function. However, higher levels of Na+–Ca2+ exchange expression in homozygotes led to pathological hypertrophy and failure with an increased interaction between the L-type Ca2+ current and Na+–Ca2+ exchange and reduced E–C coupling gain. These results suggested that the Na+–Ca2+ exchanger is capable of modulating sarcoplasmic Ca2+ handling and at high expression levels may interact with the gating kinetics of the L-type Ca2+ current by means of regulating subsarcolemmal Ca2+ levels. Despite being a central component in the regulation of cardiac E–C coupling, a newly generated mouse model with cardiac-specific conditional knock-out of the Na+–Ca2+ exchanger is viable with unchanged Ca2+ dynamics in adult ventricular myocytes. Cardiac myocytes adapt well to knock-out of the exchanger, apparently by reducing transsarcolemmal fluxes of Ca2+ and increasing E–C coupling gain possibly mediated by changes in submembrane Ca2+ levels. For E–C coupling in the murine model, which relies primarily on sarcoplasmic Ca2+ regulation, this led to the suggestion that the role of Na+–Ca2+ exchange should be thought of as a Ca2+ buffering function and not as a major Ca2+ transporter in competition with the sarcoplasmic reticulum.
KEYWORDS Na/Ca-exchanger; e–c coupling; Membrane current; Heart failure; Ca-channel
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