Ca2+ overloading causes the negative inotropic effect of doxorubicin in myocytes isolated from guinea-pig hearts.

We reported previously that conditions shown to increase Ca2+ loading augment the negative inotropic effect of doxorubicin: To examine if the negative inotropic effect is caused by Ca2+ overloading doxorubicin-induced changes in diastolic and systolic Ca2+ concentrations and twitch contractions were studied under altered Ca2+ loading. Intracellular Ca2+ concentrations ([Ca2+]i) were monitored in fura-2-loaded myocytes isolated from the ventricular muscle of guinea-pig hearts. Twitch contractions were estimated from the shortening of myocytes. In myocytes incubated at 34 degrees C a medium containing 1.2 mM CaCl2 (standard conditions), doxorubicin (100 microM) caused a significant decrease in diastolic length, and an increase in the amplitude of contraction. The positive inotropic effect of doxorubicin was followed by a negative effect. Concomitant with these changes in myocyte contractions, a monophasic increase in diastolic Ca2+ and an increase and a subsequent decrease in the amplitude of Ca2+ transients (peak [Ca2+]i minus diastolic [Ca2+]i) were observed. When the Ca2+ load of myocytes was increased by an incubation at a low temperature (25 degrees C) or in the presence of high Ca2+ in the incubation medium (2.4 mM CaCl2), diastolic [Ca2+]i was elevated. Doxorubicin further increased diastolic [Ca2+]i. Under these conditions, the doxorubicin-induced increase in the twitch contraction lasted a shorter period of time and the subsequent decrease in contraction was significantly enhanced. The peak [Ca2+]i initially increased slightly and then decreased. Thus, the decrease in the amplitude of Ca2+ transients, as well as myocyte contraction was greater compared to the corresponding values observed under the standard conditions. These changes in the contraction and Ca2+ transient developed with the same time course. The effects of the low temperature incubation were antagonized by verapamil. These results indicate that the negative inotropic effect of doxorubicin results from a decrease in the amplitude of Ca2+ transients caused by an increased diastolic [Ca2+]i and a decreased peak [Ca2+]i. These changes are likely to be caused by myocardial Ca2+ overload.