Altered Na/Ca exchange activity in cardiac hypertrophy and heart failure: a new target for therapy?

Abstract:

:Increased Na/Ca exchange (NCX) expression may be part of the genetic reprogramming in cardiac remodeling. In this review we address the following questions: (1) Is increased NCX activity a general feature of cardiac remodeling in hypertrophy and heart failure? (2) How does this contribute to the contractile and electrical phenotype of hypertrophy and heart failure? (3) Should be consider NCX a potential therapeutic target? From a review of the literature we found that NCX activity can be increased, unchanged, or even downregulated during cardiac remodeling. When NCX activity is increased, it can be considered compensatory for contractile function, but with negative side-effects, including an increased risk of arrhythmias. Changes in activity do not necessarily reflect changes in gene expression. Altered NCX activity can also be a consequence of changes in other Ca(2+) fluxes or in [Na(+)](i) homeostasis. The role of NCX in contractile alterations and arrhythmogenesis varies with the different stimuli or stages of cardiac remodeling. Pharmacological block of NCX in heart failure or hypertrophy may thus be useful, but most likely only in specific conditions, perhaps as part of a combined approach. Development of drugs that target only a specific mode of the exchanger may offer a further advantage.

journal_name

Cardiovasc Res

journal_title

Cardiovascular research

authors

Sipido KR,Volders PG,Vos MA,Verdonck F

doi

10.1016/s0008-6363(01)00470-9

subject

Has Abstract

pub_date

2002-03-01 00:00:00

pages

782-805

issue

4

eissn

0008-6363

issn

1755-3245

pii

S0008636301004709

journal_volume

53

pub_type

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