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Heart cells were loaded with sodium by treatment with toxic doses of acetyl strophanthidin. After this treatment, an increase in extracellular calcium resulted in a transient net outward sodium flux against its electrochemical gradient and in net cellular uptake of calcium. It is concluded that the free energy for the net outward sodium movement was derived from the increased calcium gradient and that these ion movements took place through the sodium-calcium exchange. While in the normal physiological state the sodium-calcium exchange produces calcium extrusion from the cell, these experiments demonstrate its reversibility.

Uphill Sodium Transport Driven by an Inward Calcium Gradient in Heart Muscle