Cytosolic Ca2+ concentration during Ca2+ depletion of isolated rat hearts

Reperfusion of isolated mammalian hearts with a Ca²⁺-containing solution after a short Ca²⁺-free period at 37°:C results in massive influx of Ca²⁺ into the cells and irreversible cell damage: the Ca²⁺paradox. Information about the free intracellular, cytosolic [Ca²⁺] ([Ca²⁺]_i) during Ca²⁺ depletion is essential to assess the possibility of Ca²⁺ influx through reversed Na⁺/Ca²⁺ exchange upon Ca²⁺ repletion. Furthermore, the increase in end-diastolic pressure often seen during Ca²⁺-free perfusion of intact hearts may be similar to that seen during ischemia and caused by liberation of Ca²⁺ from intracellular stores. Therefore, in this study, we measured [Ca²⁺]i during Ca²⁺- free perfusion of isolated rat hearts. To this end, the fluorescent indicator Indo-1 was loaded into isolated Langendorff-perfused hearts and Ca²⁺-transients were recorded. Ca²⁺-transients disappeared within 1 min of Ca²⁺ depletion. Systolic [Ca²⁺]i during control perfusion was 268±54 nM. Diastolic [Ca²⁺]i during control perfusion was 114±34 nM and decreased to 53±19 nM after 10 min of Ca²⁺ depletion. Left ventricular end-diastolic pressure (LVEDP) significantly increased from 13±4 mmHg during control perfusion after Indo-1 AM loading to 31±5 mmHg after 10 min Ca²⁺ depletion. Left ventricular developed pressure did not recover during Ca²⁺ repletion, indicating a full Ca²⁺ paradox. These results show that LVEDP increased during Ca²⁺ depletion despite a decrease in [Ca²⁺]i, and is therefore not comparable to the contracture seen during ischemia. Furthermore, calculation of the driving force for the Na⁺/Ca²⁺ exchanger showed that reversed Na⁺/Ca²⁺ exchange during Ca²⁺ repletion is not able to increase [Ca²⁺]i to cytotoxic levels.