Calcium transport in cardiovascular health and disease—The sarcolemmal calcium pump enters the stage

Calcium is known to be one of the most important ionic regulators of the heart, where it has a crucial role in contraction–relaxation. Within a single beat of the cardiomyocyte there is a 100-fold increase in the cytosolic free Ca2+ level, this must be returned to its original concentration in order to maintain the normal physiological function of the cell. Two of the mechanisms involved in returning the Ca2+ concentration back to resting levels are located at the sarcolemma; the sodium/calcium exchanger (NCX) and the sarcolemmal calcium pump. Compared to the NCX the sarcolemmal calcium pump extrudes significantly less calcium from the cardiomyocyte and has long been thought to be involved in the maintenance of low diastolic calcium levels. This review will outline recent evidence suggesting that the sarcolemmal calcium pump may in fact play a key role in signal transduction in the cardiovascular system.