uring the development of heart failure, abnormal regulation of intracellular Ca 2+ has been shown to contribute to the impaired cardiac contraction and relaxation. 1,2 Several lines of evidence have accumulated demonstrating that decreased activity or expression of Ca 2+ -ATPase (SERCA2a) in the sarcoplasmic reticulum (SR) may be an important cause of heart failure. 3,4 In addition, abnormal Ca 2+ -leakage through the SR Ca 2+ release channel, known as the ryanodine receptor (RyR2), has been demonstrated as a possible trigger for the development of heart failure. 5,6 In those studies of cases of heart failure, Ca 2+ -leak was found to be induced by the dissociation of FKBP12.6 from the RyR2 as a result of the hyperphosphorylation of the RyR2. Restoration of the defective FKBP12.6-mediated stabilization of the RyR2 either by a -blocker 7 or by a new cardioprotective agent, JTV519, 8 improved cardiac function during the development of heart failure.Angiotensin II antagonism not only prevents hypertrophy and/or interstitial fibrosis, 9,10 but also attenuates the downregulation of SERCA2a and improves intracellular Ca 2+ handling. 11,12 In a canine model of heart failure, we recently demonstrated that during the development of pacinginduced heart failure, valsartan preserved the density ofreceptors and concurrently restored SR function (increase in Ca 2+ -uptake and prevention of Ca 2+ -leak). 13 By acting on the presynaptic angiotensin-II receptor, valsartan may inhibit norepinephrine release and stimulate norepinephrine uptake back into the synaptic pool, in turn leading to a reduction in the adrenergic signal being transmitted into the cell. The fewer adrenergic signals may lead to a decrease in the level of RyR2-phosphorylation, and an inhibition of Ca 2+ -leak through the receptor. 13 Although valsartan did not improve resting cardiac function, it did enhance the contractility reserve, as suggested by an enhanced dobutamine response. 13 Chronic norepinephrine release from the synaptic pool in the hyperadrenergic state plays a crucial role in the pathogenesis of heart failure, regardless of the initial cause of the myocardial damage (hypertension, myocardial ischemia, cardiomyopathy etc). 14,15 However, heart failure is a complex disorder, and many other factors (oxidative stress, apoptosis etc) have been shown to concurrently influence the development of contractile dysfunction and/or the left ventricular (LV) remodeling process, together with the de- Background The Ca 2+ regulatory proteins in the sarcoplasmic reticulum (SR) play a key role in the pathogenesis of heart failure. In the present study the effect of chronic -receptor-stimulation on cardiac and SR functions was assessed, with or without angiotensin-II receptor antagonist treatment recently reported to have anti--adrenergic activity.
Methods and ResultsRats were treated with isoproterenol with (+) or without (-) candesartan (CAN) and then SR vesicles were isolated from the left ventricular muscle. Both Ca 2+ -uptake and the amount of SR Ca 2+ -ATPas...