Sodium-calcium exchange in regulation of cardiac contractility. Evidence for an electrogenic, voltage-dependent mechanism.

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The origin and regulatory mechanisms of tonic tension (Ca current-independent component of contractility) were investigated in frog atrial muscle under voltage-clamp conditions. Tonic tension was elicited by depolarizing pulses of 160 mV (Em = +90 mV, i.e., close to E ca) and 400--600 ms long. An application of Na-free (LiCl) or Ca-free Ringer's solutions resulted in a fast (less than 120 s), almost complete abolition of tonic tension. When [Na]o was reduced (with LiCl or sucrose as the substitutes), the peak tonic tension increased transiently and then decreased below the control level. The transient changes in tonic tension were prevented by using low-Na, low-Ca solutions where the ratios [Ca]0/[Na]40 to [Ca]o/[Na]4o were kept constant (1.1 X 10(-8) mM-3 to 8.7 X 10(-13) mM-5). Na-free (LiCl) solution elicited contractures accompanied by a membrane hyperpolarization or by an outward current even when the Na-K pump was inhibited. 15 mM MnCl2 (or 3 mM LaCl3) inhibited the development of the Na-free contracture and the related part of hyperpolarization or the outward current. In conclusion, our results indicate that tonic tension is regulated by a Na-Ca exchange mechanism. Furthermore, they suggest that this exchange could be electrogenic (exchanging three or more Na ions for one Ca ion) and thus voltage dependent. The possible contribution of an electrogenic Na-Ca exchange in the maintenance of cardiac membrane potential is discussed.