Inhibitors of Ca2+ ATPase pump of sarcoplasmic reticulum attenuate reperfusion stunning in isolated rat heart.

We tested for the first time the hypothesis that lessened uptake of Ca2+ into sarcoplasmic reticulum by inhibitors of the Ca(2+)-ATPase pump can decrease the severity of reperfusion stunning (postischemic mechanical dysfunction). We used two novel inhibitors of the Ca(2+)-ATPase pump: (a) cyclopiazonic acid (CPA, 10(-6)-10(-8)M), and (b) thapsigargin (10(-6) or 2.5 x 10(-8)M). The isolated working rat heart was subjected to 20-min global ischemia before 20-min reperfusion. The inhibitor was added either before onset of ischemia or at time of reperfusion. Reperfusion mechanical function (aortic output, AO) was measured and compared with the preischemia values. Pretreatment with CPA improved recovery of AO after 20-min reperfusion from 78.2 +/- 3.0 (n = 12) to 93.3 +/- 1.6% (n = 7) (p < 0.002) while CPA added during reperfusion only, improved AO recovery from 78.2 +/- 3.0 (n = 12) to 90.2 +/- 2.7% (n = 6) (p < 0.05). Pretreatment with thapsigargin (2.5 x 10(-8) M) improved reperfusion AO recovery from 63.5 +/- 1.1 (n = 6) to 96.8 +/- 4.2% (n = 6) (p < 0.002), but when thapsigargin was added only during reperfusion AO recovery did not change. We conclude that inhibition of the Ca2+ uptake pump represents a new principle of control of cell calcium fluxes and that CPA is more effective than thapsigargin. The proposed mechanism of protection against stunning may include inhibition of oscillations of intracellular calcium, and/or depletion of calcium in sarcoplasmic reticulum (SR).