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Sodium-hydrogen exchange in myocardial ischemia and reperfusion: A critical determinant of injury?

  • Chapter
Myocardial Ischemia: Mechanisms, Reperfusion, Protection

Part of the book series: EXS ((EXS,volume 76))

Abstract

The plasma membrane sodium-hydrogen (Na+-H+) exchanger is a ubiquitous protein which, under normal conditions, extrudes one H+ from the cell in exchange for one Na+ entering the cell. The exchanger is thought to serve a number of key physiological functions in various cell types [1]. These include the regulation of intracellular pH and cell volume (by virtue of the ability of the exchanger to transport H+ and Na+, respectively) and control of cell growth and proliferation (by mediating the actions of a number of mitogens and growth factors). Abnormalities in Na+-H+ exchanger activity have been implicated also in several pathophysiological processes, including renal acid-base disorders and cancer [1]. With respect to the cardiovascular system, the Na+-H+ exchanger is believed to be involved in the regulation of platelet [2] and vascular smooth muscle cell [3] function. Furthermore, increased exchanger activity has been linked with both hypertension [4] and the proliferative response of vascular smooth muscle cells to arterial injury [3]. However, perhaps the strongest evidence in favor of a pathophysiological role for the Na+-H+ exchanger in the cardiovascular system is in relation to the potential involvement of the cardiac sarcolemmal exchanger in mediating the unfavourable sequelae of myocardial ischemia and reperfusion. Recent reviews [5, 6] have assessed critically such evidence and the underlying cellular mechanisms; therefore, the present article will not discuss at length historical findings. Instead, its objective will be to highlight the very recent advances that have been made in: i) pharmacological inhibition of the Na+-H+ exchanger, with therapeutic benefit, in experimental studies of myocardial ischemia and reperfusion, and ii) understanding of the molecular structure and regulation of the Na+-H+ exchanger, with particular emphasis on modulation of exchanger activity by neurohormonal agents that may play a role in myocardial ischemia and reperfusion.

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Authors and Affiliations

  1. Cardiovascular Research, The Rayne Institute, St. Thomas’ Hospital, London, SEI 7EH, UK

    M. Avkiran

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  1. M. Avkiran
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Editors and Affiliations

  1. Department of Pharmacology and Toxicology, University of Western Ontario, Medical Sciences Building, N6A 5C1, London, Ontario, Canada

    Morris Karmazyn PhD (Professor and Career Investigator of the Heart and Stroke Foundation of Ontario) (Professor and Career Investigator of the Heart and Stroke Foundation of Ontario)

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© 1996 Birkhäuser Verlag Basel/Switzerland

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Avkiran, M. (1996). Sodium-hydrogen exchange in myocardial ischemia and reperfusion: A critical determinant of injury?. In: Karmazyn, M. (eds) Myocardial Ischemia: Mechanisms, Reperfusion, Protection. EXS, vol 76. Birkhäuser Basel. https://doi.org/10.1007/978-3-0348-8988-9_18

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  • DOI: https://doi.org/10.1007/978-3-0348-8988-9_18

  • Publisher Name: Birkhäuser Basel

  • Print ISBN: 978-3-0348-9857-7

  • Online ISBN: 978-3-0348-8988-9

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