Active transport and inotropic state in guinea pig left atrium

The dual effects of ouabain on 45Ca2+ transport and contractility in adult rat ventricular myocytes

We used isolated ventricular myocytes to study 45Ca2+ transport in the presence of three concentrations of ouabain (10 nM, 1 microM, and 100 microM) in Tyrode solution containing 1 mM CaCl2. The cells were quiescent and during 45Ca2+ uptake and 45Ca2+ efflux experiments, 10 nM ouabain decreased Ca2+ content, 1 microM, didn't change it appreciably, and 100 microM increased it significantly. Qualitatively, the same results were obtained at 22 degrees C and 35 degrees C. Ouabain did not significantly affect the electrical activity of isolated, electrically stimulated myocytes, but it increased the amplitude of shortenings of these myocytes in a dose-dependent manner. Thus, the positive inotropic effect of ouabain at therapeutic doses (less than or equal to 10 nM) occurs in spite of decreased Ca2+ content, while at high toxic doses the positive inotropic effect is accompanied by an increment in Ca2+ content. These data support the hypothesis that the mechanisms of positive inotropy of ouabain are different at therapeutic and toxic concentrations of this drug. Finally, our study demonstrates that the effects of low doses of ouabain are independent of the release of endogenous catecholamines.

[Na]i modulates isoproterenol's effect on Ca permeability in cultured heart cells

Isoproterenol (ISO) augments the slow inward Ca current in cardiac muscle cells. We examined the role of intracellular Na (Nai) on ISO-mediated alterations in Ca uptake in cultured chick heart cells. In 140 mM Na medium, 1 microM ISO did not measurably alter 45Ca uptake. When cells were first preincubated in Na-free medium for 5 min and then incubated in control medium with 45Ca, ISO increased 45Ca uptake by 30%. Nifedipine (10 microM), verapamil (1 microM), or dl-propranolol (1 microM) abolished the effect of ISO on 45Ca uptake. CGP 28392 (1 microM), a Ca channel agonist, increased Ca influx in a manner that was augmented by decreased Nai, similar to the ISO response. Neither ISO nor CGP 28392 altered 45Ca uptake when cells preincubated in Na-free medium were further incubated in Na-free medium containing 45Ca. Exposure of cells to Na-free medium or 25 mM K+ medium caused depolarization of the resting membrane potential to approximately -40 mV. In the absence of ISO, the 45Ca uptake in cells preincubated in Na-free or 25 mM extracellular K (Ko) medium was significantly greater than in cells preincubated in control medium. This appeared to be due partly to increased 45Ca uptake via nifedipine-sensitive pathways. These findings support the hypothesis that reduction in Nai concentration ([Na]i) enhances the ISO-induced augmentation of Ca uptake via nifedipine-sensitive pathways (presumably via slow Ca channels), probably by a direct effect on the channels.

Unsuitability of the 86Rb+ uptake method for estimation of (Na+ + K+)-ATPase activity in innervated tissues

(Na+ + K+)-ATPase activity was estimated by 86Rb+ uptake in dog saphenous vein to determine the validity of the technique in tissues that have a sympathetic innervation. When saphenous vein rings were incubated at 37 degrees C in Krebs' solution containing 86Rb+, the cardenolide acetylstrophanthidin caused a concentration-dependent inhibition of Rb+ uptake. The threshold for inhibition was approx. 10 nM acetylstrophanthidin and the maximum effect was obtained at 9 microM. In the upper part of this concentration range (greater than 1 microM) acetylstrophanthidin released noradrenaline from the sympathetic nerve terminals associated with the tissue. In this upper part of the acetylstrophanthidin concentration range the alpha-adrenoceptor antagonist phentolamine (8 microM) reduced, by up to 25%, the degree of 86Rb+ uptake inhibition caused by the cardenolide. In other experiments, saphenous vein strips were loaded with 86Rb+ and perifused with Krebs' solution containing acetylstrophanthidin. At concentrations which release noradrenaline, acetylstrophanthidin increased the efflux of 86Rb+. Phentolamine (8 microM) prevented the acetylstrophanthidin-evoked efflux of the isotope as did prior in vitro denervation of 86Rb+ loaded strips with 6-hydroxydopamine. Exogenous noradrenaline (1-100 microM) added to the perifusing fluid also caused an efflux of 86Rb+ that was attenuated by phentolamine. The data indicate for dog saphenous vein that with low concentrations of acetylstrophanthidin the extent of 86Rb+ accumulation might accurately reflect prevailing (Na+ + K+)-ATPase activity. At higher concentrations of acetylstrophanthidin, however, noradrenaline is released from the nerve endings and causes 86Rb+ efflux from the smooth muscle cells consequent upon alpha-adrenoceptor activation. Since this efflux reduces the extent of Rb+ accumulation, measurement of the latter does not adequately reflect uptake mediated by the activity of (Na+ + K+)-ATPase. This is significant because in most applications of the 86Rb+ uptake method it is the estimate of Rb+ accumulation made in the presence of a high concentration of cardenolide that forms the basis of all subsequent calculations with respect to (Na+ + K+)-ATPase activity.

The reaction of ouabain with the sodium pump of guinea-pig myocardium in relation to its inotropic effect

[3H]ouabain binding (1.85-500 nmol/l) was evaluated in resting guinea-pig papillary muscles at 1.2-12 mmol K/l. The time course of binding was biphasic. This finding excluded a homogeneous population of non-interacting binding sites of ouabain, even though the identical susceptibility of both phases to K suggested the occupation of similarly operative receptors. Concomitant with ouabain binding, intracellular Na ion activity (aiNa) increased in the presence of 2.4 or 12 mmol K/l. Occupation of the receptor molecule by ouabain, therefore, conformed to Na-pump inhibition. Although K antagonized both ouabain binding and its effect on aiNa, the antagonistic effect on aiNa was more pronounced. The reduction of passive Na influx with depolarization as well as the stimulation of the Na pump by K presumably contributed to the antagonistic effect of K. The decrease in aiNa from 8 to 5 mmol/l, when in the absence of ouabain K was raised from 2.4 to 12.0 mmol/l, confirmed the relevance of Na fluxes. Simultaneous changes in aiNa and in the force of rested-state contractions were apparent upon addition of ouabain. At 2.4 mmol K/l, increase in aiNa raised the force of contraction by constant proportions. At 12 mmol K/l, the inotropic effect produced at comparable values of aiNa was approximately tenfold higher and was susceptible to a change in extracellular Ca concentration. Increase in aiNa, however, was differently effective on force of contraction of low as compared with high values of aiNa. The influence of resting membrane potential on electrogenic Na-Ca exchange is supposed to interfere with the inotropic effectiveness of aiNa after the cell membrane depolarized from -102 mV to -65 mV with the increase of K from 2.4 to 12 mmol/l. In view of the role of both membrane potential and aiNa not just a single mechanism appeared to be involved in the control of force of contraction.

Comparison of ouabain receptors in sheep myocardium and Purkinje fibres

The conducting system of the heart has been reported to be more sensitive to the toxic effects of digitalis than the working myocardium. To investigate the molecular basis of these observations, we have characterized the ouabain receptor in Purkinje fibres and ventricular muscle of the digitalis-sensitive sheep heart using cell membrane preparations, crude homogenates and contracting heart tissues. [3H]-Ouabain binding has the following characteristics: in sheep left ventricular cell membranes, specific binding was of high affinity (KD 1.9 X 10(-9) M at 37 degrees); was co-incident with an inhibition of (Na+ + K+)-ATPase activity; and was inhibited by K+ and unlabelled cardiotonic steroids; in crude homogenates, the maximal binding capacity but not the affinity for ouabain varied in different parts of the sheep heart with Purkinje fibres containing markedly fewer binding sites (0.33 X 10(14)/g wet weight; left ventricle, 1.3 X 10(14)/g wet weight) and in isolated, contracting Purkinje fibres and right ventricular moderator band strips, concentration-response curves for [3H]-ouabain binding, increase in force of contraction and inhibition of [86Rb+]-uptake were co-incident. In both contracting tissues, a ouabain concentration of 3 X 10(-7) M occupied about 50% of the specific binding sites, gave the maximal inotropic effect without toxicity and inhibited [86Rb+]-uptake by about 50%. The maximal binding capacity was lower in contracting Purkinje fibres (2 X 10(14) binding sites/g wet weight) than in contracting moderator band strips (3.9 X 10(14) binding sites/g wet weight). The maximal inotropic effects were reached slightly faster in Purkinje fibres but toxicity also occurred faster in these fibers. We conclude that the specific ouabain binding site is the receptor mediating positive inotropy and inhibition of (Na+ + K+)-ATPase in the sheep heart. Further, this receptor is identical in both the conducting system and working myocardium but the conducting system contains many fewer receptors. This change in receptor number, rather than affinity, may underlie the increased ouabain toxicity observed in Purkinje fibres.

Relation of sodium pump inhibition to positive inotropy at low concentrations of ouabain in rat heart muscle

Low concentrations of ouabain which produce a positive inotropic effect on rat ventricular muscle do not inhibit the isolated Na+-K+-ATPase enzyme from this tissue, suggesting that these low-concentration inotropic effects are not related to sodium pump inhibition (Erdmann, Philipp & Scholz, 1980; Adams, Schwartz, Grupp, Grupp, Lee, Wallick, Powell, Twist & Gathiram, 1982). We tested this hypothesis by continuously measuring intracellular Na+ activity with Na+-selective micro-electrodes and, separately, twitch tension of rat ventricular muscle during exposure to and wash-out of ouabain. Intracellular Na+ activity (aiNa) and transmembrane potential of quiescent muscle cells averaged 8.5 +/- 2.6 mM (mean +/- S.D., n = 27) and -79.2 +/- 2.4 mV (n = 34) respectively. Low concentrations of ouabain (0.1, 0.5 and 1.0 microM) produced concentration-dependent increases in both aiNa and twitch tension. At lower concentrations of ouabain (0.01 and 0.05 microM), no detectable changes in aiNa and twitch tension were observed. The data strongly indicate that in rat ventricular muscle sodium pump inhibition is present at low concentrations of ouabain which produce positive inotropy. This is consistent with previous results in canine and sheep cardiac Purkinje fibres.

The quantitative relationship between twitch tension and intracellular sodium activity in sheep cardiac Purkinje fibres

Tension was measured in voltage clamped sheep cardiac Purkinje fibres while simultaneously measuring the intracellular Na activity (aiNa) with a recessed-tip, Na-selective micro-electrode. Inhibiting the Na-K pump either by exposing the preparation to a K-free solution or by adding the cardioactive steroid strophanthidin increased both aiNa and twitch tension and resulted in the development of tonic tension, after-contractions and a transient inward current (ITI). The increase of twitch tension was present at lower aiNa than that required to produce the other phenomena. The relationship between the magnitude of the twitch tension and aiNa was always non-linear. Twitch tension increased steeply with aiNa at first but the relationship flattened off at higher aiNa and tension eventually decreased. Over the steep range, the relationship between tension and aiNa could be represented as: twitch tension = b (aiNa)y where y had a mean value of 3.2. Changing membrane potential or [Ca2+]o changed b but had little effect on y. Mn (2 mmol/l) greatly decreased twitch tension but, at least initially, had little effect on tonic tension. The steep relationship between twitch tension and aiNa was seen, irrespective of whether the Na-K pump was inhibited either by exposure to K-free solution or to strophanthidin and whether the relationship was measured either when aiNa was increasing or after it had reached a steady state. The steep dependence of twitch tension on aiNa observed in the present work means that manoeuvres which produce even small changes of aiNa will have significant effects on contraction.

Two receptors for cardiac glycosides in the heart

Specific binding of 3H-ouabain to rat cardiac cell membranes revealed a high affinity and a low affinity site. In order to test the pharmacological significance of these different types of binding sites, specific 3H-ouabain binding, force of contraction and 86Rb+-uptake were measured simultaneously in contracting cat papillary muscles and in guinea pig atria. The results in the digitalis sensitive cat shows one type of cardiac glycoside receptors with high affinity (KD approximately 10(-7) M) for ouabain. The occupation of this receptor runs parallel with an increase in force of contraction and an inhibition of 86Rb+-uptake. In the rather digitalis insensitive guinea pig, 3H-ouabain binding also runs parallel with increased force of contraction, 86Rb+-uptake, however, is only inhibited at toxic glycoside concentrations. Thus, in rat and guinea pig heart there exist at least two different digitalis receptors--the high affinity receptor seems to be coupled to inotropic effects, the low affinity receptor is linked to inhibition of (Na+ + K+)-ATPase.