Kravtsov GM, Kam KW, Liu J, Wu S, Wong TM. Altered Ca 2ϩ handling by ryanodine receptor and Na ϩ -Ca 2ϩ exchange in the heart from ovariectomized rats: role of protein kinase A. Am J Physiol Cell Physiol 292: C1625-C1635, 2007. First published December 13, 2006; doi:10.1152/ajpcell.00368.2006.-Our previous study has demonstrated that ovariectomy (Ovx) significantly increased the left ventricular developed pressure (LVDP) and the maximal rate of developed pressure over time (ϮdP/dt max) in the isolated perfused rat heart and the effects were reversed by female sex hormone replacement. In the present investigation, we studied the effects of Ovx for 6 wk on Ca 2ϩ homeostasis that determines the contractile function. Particular emphasis was given to Ca 2ϩ handling by ryanodine receptor (RyR) and Na ϩ -Ca 2ϩ exchange (NCX ]i) in the heart. In addition, we determined the expression and contribution of protein kinase A (PKA) to the regulation of the aforementioned Ca 2ϩ handling proteins in Ovx rats. It was found that after Ovx there were 1) increased Ca 2ϩ fluxes via RyR and NCX, which were reversed not only by estrogen replacement, but more importantly by blockade of PKA; 2) an increased expression of PKA; and 3) no increase in expression of NCX and SERCA. We suggest that hyperactivities of RyR and NCX are a result of upregulation of PKA. The increased release of Ca 2ϩ through RyR and removal of Ca 2ϩ by NCX are believed to be responsible for the greater contractility and faster relaxation after Ovx. ovariectomy THERE IS INCREASING EVIDENCE that estrogen regulates the cardiac function by direct action on the myocardium. Ovariectomy (Ovx) has been shown to affect the cardiac contractility (5,22,27,28,37). A recent study from our laboratory (15) has also shown that Ovx for 6 wk significantly increased the left ventricular developed pressure (LVDP) and maximal rate of developed pressure over time (ϮdP/dt max ) in the isolated perfused rat heart and the effects were reversed by female sex hormone replacement. Moreover, the amplitude of the electrically induced intracellular Ca 2ϩ transient (E[Ca 2ϩ