Repetitive acidosis protects the ischemic heart: Implications for mechanisms in preconditioned hearts

Jennifer A. Lundmark, Nathan Trueblood, Li Feng Wang, Ravichandran Ramasamy, Saul Schaefer

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Repetitive brief ischemic episodes (ischemic preconditioning, PC) result in transient intracellular acidosis and protect the heart from subsequent ischemic injury, potentially through a protein kinase C (PKC)-dependent mechanism. We hypothesized that repetitive brief acidification of the heart without concomitant ischemia would also protect the heart from ischemic injury via a PKC-dependent mechanism. Isolated rat hearts underwent 30 min of global ischemia following control perfusion (CTL), or after PC or repetitive acidosis (RA), in the presence of absence of chelerythrine, a specific PKC inhibitor. Intracellular pH, PCr and ATP were measured using 31P NMR spectroscopy, while intracellular sodium [Na]i was measured using 23Na spectroscopy. Na,K-ATPase activity was measured prior to ischemia and on reperfusion. Both PC and RA resulted in transient acidification prior to ischemia. Ischemic injury, as assessed by creatinine kinase (CK) release on reperfusion, was reduced in both the PC and RA hearts [63 ± 14 and 16 ± 4 IU/g dry weight (dw) respectively, v 705 ± 72 IU/gdw for control; P < 0.001], and was associated with improved functional recovery on reperfusion. PC and RA each significantly reduced Na,K-ATPase activity prior to ischemia (8.18 ± 0.47 and 7.76 ± 0.54 μmol ADP/h/mg protein when compared to control (11.05 ± 0.54 μmol ADP/h/mg protein; P < 0.05), limited the rate of ATP depletion during ischemia, and resulted in more rapid normalization of [Na]i on reperfusion. Chelerythrine resulted in intermediate CK release in PC and RA hearts (443 ± 48 and 375 ± 72 IU/gdw, P < 0.001 v PC, P < 0.01 v control), but did not alter the rate of ATP depletion or [Na]i kinetics in either PC or RA hearts. PC and RA each protect the ischemic heart, having in common ATP presentation during ischemia and more rapid normalization of [Na]i on reperfusion. These effects, not modulated by protein kinase C, are consistent with the hypothesis that ATP preservation during ischemia provides enhanced substrate for sodium efflux via the Na,K-ATPase on reperfusion.

Original languageEnglish (US)
Pages (from-to)907-917
Number of pages11
JournalJournal of Molecular and Cellular Cardiology
Issue number4
StatePublished - Apr 1999


  • Adenosine triphosphate
  • Na,K-ATpase
  • Protein kinase C
  • Sodium

ASJC Scopus subject areas

  • Molecular Biology
  • Cardiology and Cardiovascular Medicine


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