MODULATION OF INTRAMITOCHONDRIAL FREE CA2-CA2+ EXCHANGE( CONCENTRATION BY ANTAGONISTS OF NA+)

Evidence has accumulated in the past decade suggesting that Ca2+ acts as a second messenger not only in the cytosol of the heart to regulate contractility, but also within the mitochondria to regulate the rate of oxidative ATP synthesis. Just as elucidation of the second messenge r pathways for Ca2+ in the cytosol has led to the development of pharm acological interventions that alter mechanical functioning of the hear t, understanding the role of Ca2+ as a second messenger within the mit ochondria and the mechanisms by which this organelle transports and re gulates Ca2+ has exciting potential for developing pharmacological int erventions that alter myocardial energy metabolism. In this article, D avid Cox and Mohammed Matlib discuss the potential consequences of pha rmacologically increasing the intramitochondrial Ca2+ concentration on myocardial energy metabolism, and suggest some pathological condition s in which such an effect may be beneficial.