Cordeiro B, Terentyev D, Clements RT. BKCa channel activation increases cardiac contractile recovery following hypothermic ischemia/ reperfusion. Am J Physiol Heart Circ Physiol 309: H625-H633, 2015. First published June 12, 2015 doi:10.1152/ajpheart.00818.2014 -activated large-conductance K ϩ (BKCa) channels are thought to provide protection during ischemic insults in the heart. Rottlerin (mallotoxin) has been implicated as a potent BKCa activator. The purpose of this study was twofold: 1) to investigate the efficacy of BKCa channel activation as a cardioprotective strategy during ischemic cardioplegic arrest and reperfusion (CP/R) and 2) to assess the specificity of rottlerin for BKCa channels. Wild-type (WT) and BKCa knockout (KO) mice were subjected to an isolated heart model of ischemic CP/R. A mechanism of rottlerin-induced cardioprotection was also investigated using H9c2 cells subjected to in vitro CP/ reoxygenation and assessed for mitochondrial membrane potential and reactive oxygen species (ROS) production. CP/R decreased left ventricular developed pressure, positive and negative first derivatives of left ventricular pressure, and coronary flow (CF) in WT mice. Rottlerin dose dependently increased the recovery of left ventricular function and CF to near baseline levels. BKCa KO hearts treated with or without 500 nM rottlerin were similar to WT CP hearts. H9c2 cells subjected to in vitro CP/R displayed reduced mitochondrial membrane potential and increased ROS generation, both of which were significantly normalized by rottlerin. We conclude that activation of BKCa channels rescues ischemic damage associated with CP/R, likely via effects on improved mitochondrial membrane potential and reduced ROS generation. ischemia; mitochondria; potassium channel; reperfusion; reactive oxygen species (18,21,23,27,28,35). More recently, the Ca 2ϩ -activated large-conductance K ϩ (BKCa) channel has also been recognized as having potent cardioprotective properties. BKCa activation reduces myocardial infarction, promotes survival, and improves cardiac and vascular function following severe ischemic insults (3,7,9,12,31,32,34,36). In addition, BKCa channels may be more potently cardioprotective than mitoK ATP channels (17).
NEW & NOTEWORTHYActivation of BKCa channels may also provide effective cardioprotection in the case of reversible ischemic insults associated with cardiac surgery for coronary artery bypass grafting or valve repair. Cardiac surgeries with cardioplegia and cardiopulmonary bypass provide protection to the heart and tissue from damage that could otherwise prove lethal or result in massive myocardial infarction (8,19,25). However, surgical cardioprotection is not perfect, and ischemic insults associated with cardiac surgery include reduced contractile function after surgery (myocardial stunning) and propensity for vasoconstriction and vasospasm in the coronary circulation (30).We recently demonstrated that the small molecule rottlerin (mallotoxin) enhances cardioprotection following ischemic cardioplegi...