Liu, Shi J., and Richard H. Kennedy. Positive inotropic effect of ceramide in adult ventricular myocytes: mechanisms dissociated from its reduction in Ca 2ϩ influx. Am J Physiol Heart Circ Physiol 285: H735-H744, 2003. First published May 1, 2003 10.1152 10. /ajpheart.01098.2002 sphingolipid metabolite produced by activation of sphingomyelinase, has been previously shown to reduce L-type Ca 2ϩ channel current (ICa,L) in adult rat ventricular myocytes; however, its effect on contractile function is unknown. In this study, we investigated the effects of ceramide on excitationcontraction coupling in adult ventricular myocytes and on left ventricular (LV) function in isolated hearts. Surprisingly, in patch-clamped myocytes, ceramide increased contraction concomitant with reductions in ICa,L. In intact myocytes, ceramide increased cell shortening (CS) concurrently with enhancing maximum rates of shortening and relaxation and the duration of contraction. Ceramide also increased the amplitudes of postrest potentiated (PRP) contraction. In fura-PE3-loaded myocytes, ceramide increased systolic Ca 2ϩ and the magnitude and maximum rates of the rising and declining phases of Ca 2ϩ transients. Ceramide-elicited decreases in magnitudes of PRP relative to steady-state contraction and the Ca 2ϩ transient suggest an increased fractional Ca 2ϩ release from the sarcoplasmic reticulum (SR). However, ceramide slightly reduced the caffeine-induced Ca 2ϩ transient and had no significant effect on the amplitude of the PRP-elicited Ca 2ϩ transient. Additionally, the ceramide-induced upward shift in the relationship of contraction and the Ca 2ϩ transient and increase in the Ca 2ϩ responsiveness of CS suggest an increase in myofilament Ca 2ϩ sensitivity. In isolated hearts, ceramide increased LV developed pressure and maximum rates of contraction and relaxation at balloon volumes of 30-50 l. In summary, regardless of decreasing ICa,L, ceramide elicits distinct positive inotropic and lusitropic effects, resulting probably from enhanced SR Ca 2ϩ release and uptake, and increased Ca 2ϩ sensitivity of ventricular myocytes. calcium; lipid metabolites; excitation-contraction coupling; contractile function; sphingolipid; heart CERAMIDE (N-acylated sphingosines), a naturally occurring sphingolipid, is produced predominantly by the activation of neutral and/or lysosomal acidic sphingomyelinase (4,20,22). With the use of a natural form of ceramide and exogenous, membrane-permeable, synthetic ceramides with a short carbon chain (e.g., C 2 -ceramide), studies have shown that ceramides mediate some biological effects of IL-1 and TNF-␣, two primary proinflammatory cytokines (32). Ceramides have been shown to stimulate the production of other cytokines (e.g., IL-2 and IL-6) (28) and prostaglandin E 2 (2, 3), induce transcription factors (e.g., NF-B) (3,11,32,37), suppress cell growth (19), and induce apoptosis (15,16,21,23). Moreover, studies in cardiac myocytes have shown that intracellular ceramide levels are increased in response to IL-1 stimulati...