Aprikalim reduces the Na+-Ca2+ exchange outward current enhanced by hyperkalemia in rat ventricular myocytes

The effects of nickel chloride on papillary muscle contractility under normothermic and hypothermic conditions: Comparison of active and hibernating ground squirrels (Urocitellus undulatus) with Wistar rats

Extracellular Ca2+ plays a pivotal role in the regulation of cardiac contractility under normal and extreme conditions. Here, by using nickel chloride (NiCl2), a non-specific blocker of extracellular Ca2+ influx, we studied the input of extracellular Ca2+ on the regulation of papillary muscle (PM) contractility under normal and hypothermic conditions in ground squirrels (GS), and rats. By measuring isometric force of contraction, we studied how NiCl2 affects force-frequency relationship and the rest effect in PM of these species at 30 °C and 10 °C. We found that at 30 °C 1.5 mM NiCl2 significantly reduced force of contraction across entire frequency range in active GS and rats, whereas in hibernating GS force of contraction was reduced at low and high frequency range. Additionally, NiCl2 evoked spontaneous contractility in rats but not GS PM. The rest effect was significantly reduced by NiCl2 for active GS and rats but not hibernating GS. At 10 °C, NiCl2 fully reduced contractility in active GS and, to a lesser extent, in rats, whereas in hibernating GS it was significant only at 0.3 Hz. The rest effect was significantly reduced by NiCl2 in both active and hibernating GS, whereas it was unmasked in rats that had high contractility under hypothermic conditions in control. Our results show a significant contribution of extracellular Ca2+ to myocardial contractility in GS not only in active but also in hibernating states, especially under hypothermic conditions, whereas limitation of extracellular Ca2+ influx in rats under hypothermia can play protective role for myocardial contractility.

Protection of coronary endothelial function during cardiac surgery: potential of targeting endothelial ion channels in cardioprotection

Vascular endothelium plays a critical role in the control of blood flow by producing vasoactive factors to regulate vascular tone. Ion channels, in particular, K⁺ channels and Ca²⁺-permeable channels in endothelial cells, are essential to the production and function of endothelium-derived vasoactive factors. Impairment of coronary endothelial function occurs in open heart surgery that may result in reduction of coronary blood flow and thus in an inadequate myocardial perfusion. Hyperkalemic exposure and concurrent ischemia-reperfusion during cardioplegic intervention compromise NO and EDHF-mediated function and the impairment involves alterations of K⁺ channels, that is, K_ATP and K_Ca, and Ca²⁺-permeable TRP channels in endothelial cells. Pharmacological modulation of these channels during ischemia-reperfusion and hyperkalemic exposure show promising results on the preservation of NO and EDHF-mediated endothelial function, which suggests the potential of targeting endothelial K⁺ and TRP channels for myocardial protection during cardiac surgery.

Effect of cardioplegic and organ preservation solutions and their components on coronary endothelium-derived relaxing factors

Cardioplegic (and organ preservation) solutions were initially designed to protect the myocardium (cardiac myocytes) during cardiac operation (and heart transplantation). Because of differences between cardiac myocytes and vascular (endothelial and smooth muscle) cells in structure and function, the solutions may have an adverse effect on coronary vascular cells. However, such effect is often complicated by many other factors such as ischemia-reperfusion injury, temperature, and perfusion pressure or duration. To evaluate the effect of a solution on the coronary endothelial function, a number of points should be taken into consideration. First, the overall effect on endothelium should be identified. Second, the effect of the solution on the individual endothelium-derived relaxing factors (nitric oxide, prostacyclin, and endothelium-derived hyperpolarizing factor) must be distinguished. Third, the effect of each major component of the solution should be investigated. Lastly, the effect of a variety of new additives in the solution may be studied. Based on available literature these issues are reviewed to provide information for further development of cardioplegic or organ preservation solutions.

Verapamil and mild hyperkalemia in hemodialysis patients: A potentially hazardous association

During the past 3 years, 3 patients undergoing intermittent hemodialysis (or about to do so) in our hospital developed a third-degree atrioventricular block while being treated with verapamil for blood pressure or supraventricular arrhythmia. In the 3 cases, mild hyperkalemia was concomitant. The medical history of these patients revealed no intrinsic cause of atrioventricular conduction disturbance. We report herein the 3 cases and draw attention to the risks of atrioventricular block in this particular context.

Release of Nitric Oxide and Endothelium-Derived Hyperpolarizing Factor (EDHF) in Porcine Coronary Arteries Exposed to Hyperkalemia: Effect of Nicorandil

BACKGROUND

Although the detrimental effect of hyperkalemia on coronary endothelium has been reported, there is no direct evidence regarding the effect of hyperkalemic exposure on nitric oxide (NO) release from the coronary endothelium. In addition, it is unclear whether nicorandil, a KATP channel opener, used as hyperpolarizing cardioplegia or added in hyperkalemic cardioplegic solution may protect endothelial function during cardiac surgery. The present study was designed to clarify NO release and the function of endothelium-derived hyperpolarizing factor (EDHF) in coronary circulation with respect to the effect of hyperkalemia and nicorandil.

METHODS

Nitric oxide was measured by using a NO-specific electrode, and EDHF-mediated relaxation was investigated in a myograph. Substance P- and calcium ionophore A23187-induced NO release was compared in porcine left circumflex coronary arteries before and after 1-hour exposure to 20 mM potassium (K+) at 37 degrees C. In coronary microarteries (diameter 200 to 450 microm), precontracted with U46619, in the presence of indomethacin (7 microM), NG-nitro-L-arginine (300 microM), and oxyhemoglobin (20 microM), EDHF-mediated relaxation was induced by bradykinin (-10 to -6.5 log M) after incubation with Krebs (control) or 20 mM K+ with or without 10 microM nicorandil at 37 degrees C for 1 hour.

RESULTS

Neither substance P (58.8 +/- 5.0 versus 66.2 +/- 7.2 nmol/L) nor A23187 (86.6 +/- 9.0 versus 82.4 +/- 9.2 nmol/L in control) induced NO release was altered by hyperkalemic exposure (p > 0.05). In contrast, EDHF-mediated relaxation was decreased from 84.2% +/- 3.8% to 42.3% +/- 6.0% (p < 0.001) that was partially restored by nicorandil (50.7% +/- 5.5%, p < 0.05).

CONCLUSIONS

Exposure to potassium at 20 mM does not affect NO release but impairs EDHF-mediated relaxation in coronary arteries. Supplementation of nicorandil in hyperkalemic cardioplegia may provide a protective effect on EDHF-related endothelial function.

Participation of Na/Ca-exchanger and sarcoplasmic reticulum in the high [K]-protection against ischaemia-reperfusion dysfunction in rat hearts

AIM

Na/Ca-exchanger (NCX) and sarcoplasmic reticulum (SR) roles during the protection by a cardioplegic solution (25 mm K and 0.5 mm Ca, CPG) against ischaemia-reperfusion was studied.

METHODS

Contractile performance (CP) and high energy phosphates contents (HEP) were evaluated in isolated ventricles from rats. They were pre-treated with Krebs (C) or CPG and submitted to no-flow ischaemia and reperfusion (I-R). KB-R7943 5 microm (inhibitor of NCX in reverse mode), 8 mm caffeine and ionic changes were used pre-ischaemically to evaluate each pathway role.

RESULTS

During R, CP recovered to 77 +/- 8% of basal in CPG-hearts vs. 55 +/- 8% (P < 0.05) in C-ones. CPG avoided the increases in end diastolic pressure (LVEDP) and in PCr/ATP ratio during I-R. Low [Na]o (78 mm) under both, CPG-2 mm Ca and C, increased further the LVEDP during I-R. LVEDP was also transiently increased by caffeine-CPG, but not modified by KB-R7943. The recovery of CP during reperfusion of CPG-hearts was decreased either, by caffeine (to approximately 75%), low [Na]o-2 mm Ca-CPG (to approximately 40%) and KB-R7943 (to approximately 16%).

CONCLUSIONS

CPG protected hearts from ischaemic contracture by attenuating the fall in ATP and removing diastolic Ca by means of NCX in forward mode. Moreover, CPG induces higher CP recovery during reperfusion by participation of SR and NCX in reverse mode. This work remarks the use of CPG based on the functional role of these Ca handling-mechanisms in a pathophysiological condition as ischaemia-reperfusion.

Nickel and extracellular acidification inhibit the water permeability of human aquaporin-3 in lung epithelial cells

Nickel is a common cause of pneumoconiosis. Here, we show that nickel inactivates aquaporin (AQP)-3, the water channel expressed apically in epithelial cells of human terminal airways. Human AQP3 was transiently transfected into human lung cells, and water permeability was measured in transfected and neighboring untransfected cells. Incubation with NiCl2 rapidly, dose-dependently, and reversibly decreased water permeability in AQP3-expressing cells. Acidification of the extracellular medium also caused rapid, dose-dependent, and reversible inhibition of AQP3. Sensitivity of AQP3 to nickel was lower at alkaline pH than at neutral and acidic pH. Cells transfected with human AQP4 and AQP5, which are also expressed in airway epithelia, were insensitive to nickel and extracellular acidification. Zinc and cadmium, other common causes of pneumoconiosis, had no effect on the water permeability of AQP3. Three extracellular residues, Trp128, Ser152, and His241, were responsible for the blocking effect of nickel on human AQP3. Ser152 was identified as a common site for nickel and pH sensitivity. His53, Tyr124, and His154 were also involved in regulation of AQP3 by extracellular pH. In addition, the aromatic side chain of His154 was shown to be important for the water permeability of AQP3. Our results imply that nickel and extracellular pH may modulate lung water clearance and that defective water clearance may be an early component of nickel-induced lung disease.