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Cardiovascular Research 2005 67(2):198-207; doi:10.1016/j.cardiores.2005.04.031
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Copyright © 2005, European Society of Cardiology

Na+–Ca2+exchange in the regulation of cardiac excitation–contraction coupling

Hannes Reutera,*, Christian Pottb,c, Joshua I. Goldhaberb,c, Scott A. Hendersonb,c, Kenneth D. Philipsonb,c and Robert H.G. Schwingera

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


Time for primary review 21 days


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