Ion Transport during Hypothermia in Cultured Heart Cells: Implications for Protection of the Immature Myocardium

In non-adult hearts, hypothermia influences protection of the myocardium by exerting effects on specific ion transporters, thereby altering the normal balance between ion pumps and ion leaks. We studied the effects of hypothermia on individual ion transporters in cardiac myocytes to better understand how to preserve the normal ion balance at reduced temperatures, and thereby enhance myocardial protection. Cardiocytes obtained from 11 day chick embryos were cultured for 3 days, and then equilibrated in a glucose containing HEPES-TRIS buffered salt solution at 37°C (pH = 7.4). The cells were incubated at 10 ± 2°C for 5 to 360 min in the absence or presence of specific ion transport inhibitors, and ion contents were assessed by atomic absorption spectrophotometry. Intracellular Na content increased from approximately 90 nmol/mg protein (control) to 2-3 times this value within 30 min, and then returned to control levels by 60 min. This increase in Na was accompanied by a small rise in total Ca (1.5 times control). Acidotic pH (6.4) and/or ethylisopropyl amiloride (100 μM), but not bumetanide (100 μM) prevented the rise in Na content, suggesting the Na/H exchanger contributed to the initial Na influx. Ouabain (1 mM), exacerbated the Na rise and prevented its recovery to control values at 10°C, although Rb flux measurements revealed only a low level of Na/K ATPase activity throughout 240 min at 10°C (15% of 37°C activity). Calcium content rose to 10 times control values in the presence of ouabain at 37°C only, consistent with a lack of significant Na/Ca exchange activity during hypothermia. In conclusion, the effects of hypothermia on ion pumps and ion leaks in embryonic heart cells are as follows: (1) a low level of Na/K ATPase activity contributes significantly to ion regulation; (2) activity of the Na/H exchanger must be attenuated to minimize Na loading; (3) slowing of the Na/Ca exchanger may reduce Ca induced cell injury. We suggest that reducing Na/H exchange activity during hypothermia, using cardioplegic solutions with a slightly acidic pH or with added ethylisopropyl amiloride, may enhance the protective effects of hypothermia in non-adult hearts.