The Na
+-Ca
2+ exchanger current was measured in single guinea pig ventricular myocytes, using the whole-cell voltage-clamp technique, and intracellular free calcium concentration ([Ca
2+]
i) was monitored simultaneously with the fluorescent probe Indo-1 applied intracellularly through a perfused patch pipette. In external solutions, which have levels of Ca
2+ (∼66 μM Ca
2+) thought low enough to inhibit exchanger turnover, the removal of external Na
+ (by replacement with Li
+) induced both an outward shift of the holding current and an increase in [Ca
2+]
i, even though the recording pipette contained 30 mM bis(O-aminophenoxy)ethane-N,N,N′,N′-tetraacetic acid (BAPTA), sufficient to completely block phasic contractions. The effects of Na
+ removal were blocked either by the extracellular application of 2 mM Ni
2+ or by chelating extracellular Ca
2+ with 1 mM EGTA. In the presence of 10 μM Ryanodine, the effects of external Na
+ substitution with Li
+ on both membrane current and [Ca
2+]
i were attenuated markedly in amplitude and at a much slower time course. Reversal potentials were estimated by using ramp pulses and by defining exchange currents as the Ni
2+-sensitive components. The experimental values of the reversal potential and [Ca
2+]
i were used to calculate cytosolic Na
+ ([Na
+]
i) by assuming an exchanger stoichiometry of 3Na
+ : 1Ca
2+. These calculations suggested that in the nominal absence of external Ca
2+ (∼66 μM under our experimental conditions), the exchanger operates at −40 mV as though ∼40 mM Na
+ had accumulated in the vicinity of the intracellular binding sites. We conclude that under the conditions of low extracellular Ca
2+ and high intracellular Ca
2+ buffering, the Na
+-Ca
2+ exchanger can still generate sufficient Ca
2+ influx on the removal of external Na
+ to markedly increase cytosolic free Ca
2+.
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