The effect of an Na+/H+ exchange inhibitor, SM-20550, on ischemia/reperfusion-induced endothelial dysfunction in isolated perfused rat hearts

The aim of this study was to test the protective effect of an Na+/H+ exchange (NHE) inhibitor, SM-20550, on ischemia/reperfusion-induced endothelial dysfunction. Isolated rat hearts were subjected to 30 min of global ischemia followed by 20 min of reperfusion and their responses to the endothelial-dependent vasodilator, acetylcholine, and the endothelial-independent vasodilator, nitroglycerin, before and after ischemia were examined. Acetylcholine-induced relaxation was impaired after ischemia/reperfusion while nitroglycerin induced relaxation was not. Administration of 1-10 nmol/l SM-20550 N-(aminoiminomethyl)-1,4-dimethyl-1H-indole-2-carboxamide methanesulfonic acid] before and after ischemia prevented impairment of acetylcholine-induced relaxation. To further understand the mechanism of SM-20550 in protecting endothelial function, we measured the inhibitory activity of SM-20550 on NHE in cultured endothelial cells. SM-20550 (1-100 nmol/l) inhibited recovery from acidosis induced by an NH4Cl prepulse in a concentration-dependent manner. Oxygen radicals from endothelial cells and leukocytes are one of the major sources of endothelial cell injury during ischemia and reperfusion. Consequently, we tested the effect of SM-20550 on H2O2-induced endothelial cell injury. SM-20550 (100-1,000 nmol/l) prevented H2O2-induced cell injury measured by lactate dehydrogenase assay. In conclusion, SM-20550 inhibited NHE in endothelial cells, protected ischemia/reperfusion-induced endothelial dysfunction and prevented H2O2-induced endothelial cell injury at higher concentrations.