Diabetic cardiomyopathy in rats: biochemical mechanisms of increased tolerance to calcium overload.

Abundant information is now available about changes in subcellular organelles that are responsible for the impaired intracellular calcium homeostasis in diabetic cardiomyopathy. Some of these changes concern heart sarcolemma and include decrease in the following variables: calcium binding, influx of calcium through the L-type calcium channels, (Na,K)-ATPase activity and its affinity to sodium, Na(+)-Ca2+ exchange, H(+)-Na+ exchange, etc. Diabetic hearts also exhibited increased tolerance to calcium, but none of the above membrane perturbations were clearly identified as the source of this effect. The present study was undertaken in order to identify those alterations appearing in diabetes which are specific for the diabetic heart only. Our interest was focused on changes in sarcolemmal ATPase activities, particularly those of the (Na,K)-ATPase and its activation by increasing concentrations of sodium and potassium. Studies were performed in the acute (8 days) and chronic (63 days) phase of development of insulin-dependent diabetic cardiomyopathy. Wistar rats were made diabetic by administration of streptozotocin. To test the effect of excess calcium, the well-established model of calcium paradox was used. From the results obtained the following conclusions have been made: (a) diabetic hearts exceed normal hearts in their tolerance to calcium overload. In this respect the effect of chronic diabetes is more pronounced than the effect of acute diabetes; (b) the activities of sarcolemmal ATPases in diabetic hearts remain relatively well preserved. For this reason and with respect to modulation of calcium tolerance, the changes in specific properties of the ATPases, particularly those in the (Na,K)-ATPase, outweigh the importance of perturbations in their activities; (c) the enormous decrease in affinity of the (Na,K)-ATPase to sodium (increased K(m) value) monitored in calcium paradox in acute diabetic hearts was absolutely missing in "calcium-tolerant" chronic diabetic hearts. This observation pointed to a possible relation that may exist between the specific properties (Na,K)-ATPase adapted to work in chronic diabetic hearts and the enhanced calcium tolerance of those hearts; (d) the specific mechanism responsible for improved activation of the (Na,K)-ATPase by sodium and also partially responsible for potassium ions, which is clearly manifested in chronic diabetic hearts upon calcium paradox, still remains to be elucidated. Nevertheless, it could be assumed that the same mechanism may be also co-responsible for the enhanced tolerance of diabetic hearts to calcium.