Increased Exchange Current but Normal Ca Transport via Na -Ca Exchange During Cardiac Hypertrophy After Myocardial Infarction

Hypertrophied and failing cardiac myocytes generally show alterations in intracellular Ca handling associated with changes in the contractile function and arrhythmogenicity. The cardiac Na -Ca exchange (NCX) is an important mechanism for Ca extrusion and cell relaxation. Its possible involvement in changes of excitation-contraction coupling (EC-coupling) with disease remains uncertain. We analyzed the NCX function in rat ventricular myocytes 5 to 6 months after experimental myocardial infarction (PMI) produced by left coronary artery ligation and from sham-operated (SO) hearts. Caged Ca was dialyzed into the cytoplasm via a patch-clamp pipette and Ca was released by flash photolysis to activate NCX and measure the associated currents (INaCa), whereas [Ca 2 ]i changes were simultaneously recorded with a confocal microscope. INaCa density normalized to the [Ca 2 ]i jumps was 2.6-fold higher in myocytes from PMI rats. The level of total NCX protein expression in PMI myocytes was also increased. Interestingly, although the INaCa density in PMI cells was larger, PMI and SO myocytes presented virtually identical Ca transport via the NCX. This discrepancy was explained by a reduced surface/volume ratio (34.8%) observed in PMI cells. We conclude that the increase in NCX density may be a mechanism to maintain the required Ca extrusion from a larger cell to allow adequate relaxation. (Circ Res. 2002;91:323-330.)