. Cardiac protection by mitoKATP channels is dependent on Akt translocation from cytosol to mitochondria during late preconditioning. Am J Physiol Heart Circ Physiol 290: H2402-H2408, 2006; doi:10.1152/ajpheart.00737.2005.-This investigation elucidates the Akt/mitochondrial ATP-sensitive K ϩ (mitoKATP) channel signaling pathway in late pharmacological preconditioning, using the mitoKATP channel openers BMS-191095 (BMS) and diazoxide (DE). BMS (1 mg/kg ip) and DE (7 mg/kg ip) alone or BMS plus wortmannin (WTN, 15 g/kg ip), an inhibitor of phosphatidylinositol 3-kinase, and BMS plus 5-hydroxydecanoic acid (5-HD, 5 mg/kg ip), an inhibitor of mitoKATP channels, were administered to male mice. Twenty-four hours later, hearts were isolated and subjected to 40 min of ischemia and 120 min of reperfusion via Langendorff's apparatus. Both BMS and DE reduced left ventricular end-diastolic pressure and increased left ventricular developed pressure as well as reduced LDH release. Coadministration of BMS and WTN abolished the beneficial effects of BMS on cardiac function. Moreover, BMS and DE accelerated Akt phosphorylation in cardiac tissue as determined by Western blot analysis and also significantly reduced apoptosis compared with ischemic control. WTN significantly suppressed BMS-induced Akt phosphorylation, whereas 5-HD had no effect on Akt phosphorylation in cytosol, and the effect of BMS on apoptosis was abolished. It is concluded that the cardioprotective effect by mitoKATP channels is attributed to the translocation of phosphorylated Akt from cytosol to mitochondria. BMS-191095; diazoxide; apoptosis; mitochondrial ATP-sensitive K channels APOPTOSIS AND NECROSIS are generally responsible for myocyte death during ischemia and reperfusion. Necrosis is a rapidly occurring event of cell death that triggers a significant inflammatory response. Typically, cellular changes during necrosis include severe cellular and organelle swelling, denaturation and coagulation of cytoplasmic proteins, and breakdown of cell organelles. Also, there is a depletion of ATP that may be due to a lack of oxygen, a loss of calcium homeostasis, and defects in membrane permeability, which eventually leads to cell death (6). Apoptosis is a genetically controlled programmed cell death and is also responsible for cell injury in the ischemic myocardium. Simultaneous occurrence of both apoptosis and necrosis in myocardium determines the lethality of myocardial injury after ischemia and reperfusion (2,14,19). The cardioprotective effects of protein kinase B (Akt) have been mainly attributed to the reduction of myocardial apoptosis and have a pivotal role in vascular homeostasis and angiogenesis (21). The antiapoptotic activity of Akt is mediated through the activation of the phosphatidylinositol 3-kinase (PI3K) system (10). There is a strong support to the hypothesis that mitochondrial ATPsensitive K ϩ (mitoK ATP ) channel openers like BMS-191095 (BMS) and diazoxide (DE) activate PI3K/Akt pathway during late preconditioning. Bijur and Jope (3) have pro...