Pacing-induced heart failure in the dog recapitulates many of the
electrophysiological and hemodynamic abnormalities of the human disease;
however, the mechanisms underlying altered Ca$^2+$ handling have
not been investigated in this model. We now show that left ventricular
midmyocardial myocytes isolated from dogs subjected to 3 to 4 weeks
of rapid pacing have prolonged action potentials and Ca$^2+$
transients with reduced peaks, but durations approximately 3-fold
longer than controls. To discriminate between action potential effects
on Ca$^2+$ kinetics and direct changes in Ca$^2+$ regulatory
processes, voltage-clamp steps were used to examine the time constant
for cytosolic Ca$^2+$ removal (tauCa). tauCa was prolonged by
just 35\% in myocytes from failing hearts after fixed voltage steps
in physiological solutions (tauCa control, 216+/-25 ms, n=17; tauCa
failing, 292+/-23 ms, n=22; P<0.05), but this difference was markedly
accentuated when Na$^+$/Ca$^2+$ exchange was eliminated (tauCa
control, 282+/-30 ms, n=13; tauCa failing, 576+/-83 ms, n=11; P<0.
005). Impaired sarcoplasmic reticular (SR) Ca$^2+$ uptake and
a greater dependence on Na$^+$/Ca$^2+$ exchange for cytosolic
Ca$^2+$ removal was confirmed by inhibiting SR Ca$^2+$ ATPase
with cyclopiazonic acid, which slowed Ca$^2+$ removal more in
control than in failing myocytes. beta-Adrenergic stimulation of
SR Ca$^2+$ uptake in cells from failing hearts sufficed only
to accelerate tauCa to the range of unstimulated controls. Protein
levels of SERCA2a, phospholamban, and Na$^+$/Ca$^2+$ exchanger
revealed a pattern of changes qualitatively similar to the functional
measurements; SERCA2a and phospholamban were both reduced in failing
hearts by 28\%, and Na$^+$/Ca$^2+$ exchange protein was increased
104\% relative to controls. Thus, SR Ca$^2+$ uptake is markedly
downregulated in failing hearts, but this defect is partially compensated
by enhanced Na$^+$/Ca$^2+$ exchange. The alterations are
similar to those reported in human heart failure, which reinforces
the utility of the pacing-induced dog model as a surrogate for the
human disease.