Distinct roles of peroxynitrite and hydroxyl radical in triggering stunned myocardium-like impairment of cardiac myocytes in vitro

Myocardial stunning is characterized by the impairment of excitation-contraction coupling via a decrease in myofilament Ca²⁺ responsiveness, thought to be triggered by hydroxyl radicals (·OH) generated upon reperfusion. Since peroxynitrite is also expected to be produced during reperfusion, we examined whether it can induce a stunned myocardium-like impairment of cardiac myocytes. Its effect on cultured cardiac myocytes was compared with that of hydrogen peroxide (H₂O₂), ·OH source. Infusion of peroxynitrite (0.2 mM) induced a decrease in cell motion and a complete arrest in diastole at 2.9 ± 0.3 min, which coincided with an elevation in Ca²⁺]_i. Arrest induced by infusion of H²O² (10 mM) was not associated with an increase in Ca²⁺]_i. The ATP content was unaffected by peroxynitrite (control, 34.3 ± 3.4: + peroxynitrite, 32.9 ± 3.5 nmol/mg protein) and the cells remained viable. Sulfhydryl (SH) content was decreased by peroxynitrite, but not by H₂O₂. The membrane fluidity (a measure of peroxidation of the membrane lipids) was not affected by peroxynitrite, but was decreased by H₂O₂. Onset time of arrest was unaffected by deferoxamine (0.2 mM), but was delayed by DTT (10 mM) (from 2.9 ± 0.3 to 19.2 ± 1.6 min). Nitrotyrosine content was unchanged by peroxynitrite, and its augmentation with Fe³⁺/EDTA (1 mM) was not associated with a shortened onset time of arrest. The function of the Na⁺/Ca²⁺ exchanger was impaired by peroxynitrite, but not by H₂O₂. Peroxynitrite and H₂O₂ each induce arrest, but only the former increases Ca²⁺]_i. One of the mechanisms of the increase in Ca²⁺]_i is Na⁺/Ca²⁺ exchanger dysfunction. The impairments were induced through SH oxidation by peroxynitrite, but through lipid peroxidation by H₂O₂. Myocardial stunning may be induced by both species in concert.