“…Secondly, a proton-induced slowing of Ca2" uptake by the sarcoplasmic reticulum (Mandel et al 1982) (Earm & Irisawa, 1986) and since Ca2" is normally extruded by the Na'-Ca2+ exchanger in resting muscle (for review see Eisner & Lederer, 1989) (Kleber, 1983). It is also likely that changes in the action potential which become prominent after 10-15 min are involved in the subsequent decline in Ca2`transients which occurs later in ischaemia (Allen et al 1989). (ii) A number of studies have suggested that operation of the Na+-H+ exchanger leading to Na+ and Ca2`loading is the mechanism by which acidosis causes increased [Ca2+], during ischaemia (Tani & Neely, 1989;Pike, Kitakaze & Marban, 1990 (Kleber, 1983;Vanheel et al 1990) and, as noted above, Vanheel et al suggested that extracellular acidosis was inhibiting the exchanger. This was also the basis for the hypothesis of Lazdunski et al (1985) in which it was proposed that reactivation of the Na+-H+ exchanger on reperfusion led to Na+ and therefore Ca2`loading.…”