Cytosolic sodium concentration regulates contractility of cardiac muscle.

The present chapter provides experimental evidence to show that intracellular Na+ concentration regulates cardiac contractility effectively by altering intracellular Ca2+ concentration via the Na-Ca exchange. This steep coupling between the Na+ and Ca2+ electrochemical gradients implies that a change in intracellular Na+ concentration is accompanied by a concomitant change in intracellular Ca2+ concentration (and, therefore, contractility). Under the physiologic conditions, each cardiac action potential alters intracellular Na+ concentration in a dynamic manner. Therefore, Na-Ca exchange can regulate cardiac contraction from a beat-to-beat basis.