Heat shock protein 70 (HSP70) mediates delayed cardioprotection of preconditioning. Cytosolic calcium ([Ca 2ϩ ] i ) overload precipitates injury, whereas attenuation of [Ca 2ϩ ] i overload is believed to be responsible for cardioprotection. There is evidence suggesting a link between HSP70 and [Ca 2ϩ ] i homeostasis. We hypothesize that activation of HSP70 by preconditioning may restore [Ca 2ϩ ] i homeostasis altered by ischemic insults. To test the hypothesis, we determined the effects of preconditioning with metabolic inhibition or pretreating with U50,488H [trans-(ϩ)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]-benzeneacetamide (a -opioid receptor agonist)] on viability and injury, HSP70 expression, and [Ca 2ϩ ] i in ventricular myocytes subjected to metabolic inhibition and anoxia (MI/A), with blockade of HSP70 synthesis. In myocytes with vehicle pretreatment, the percentage of dead cells determined by trypan blue exclusion, the injury reflected by release of lactate dehydrogenase, and the resting [Ca 2ϩ ] i measured by spectrofluorometry significantly increased, whereas the amplitude of electrically induced [Ca 2ϩ ] i transient decreased, after 10 min with 10 mM 2-deoxy-D-glucose and 10 mM sodium dithionite, known to cause MI/A. However, when myocytes were subjected for 30 min to either 20 mM lactate and 10 mM 2-deoxy-D-glucose (MIP) or 30 M U50,488H (UP) 20 h before MI/A, the changes in viability and injury, and [Ca 2ϩ ] i responses were significantly attenuated. These were accompanied by a significantly increased HSP70 expression. Furthermore, blockade of HSP70 synthesis with selective antisense oligonucleotides abolished the beneficial effects of MIP or UP. This study provides first evidence that activation of HSP70 induced by preconditioning, which conferred delayed cardioprotection, restored partially the [Ca 2ϩ ] i homeostasis altered by ischemic insults.Preconditioning with metabolic inhibition (MIP) or stimulation of -opioid receptor (-OR) with a -OR agonist, U50,488H (UP), has been shown to confer delayed cardioprotection (Wu et al., 1999;Zhou et al., 2001). The protective effect of MIP or UP was accompanied by an enhanced expression of a stress-inducible heat shock protein 70 (HSP70) and blockade of the HSP70 synthesis with a selective antisense (AS) oligonucleotides abolished the protection, indicating that HSP70 mediated the delayed cardioprotection of MIP or UP (Zhou et al., 2001). However, the signaling transduction mechanisms of activation of HSP70 leading to cardioprotection are far from clear.Intracellular Ca 2ϩ ([Ca 2ϩ ] i ) overload is widely believed to be a precipitating cause of myocardial injury upon ischemia and reperfusion (IR) based on the observation that [Ca 2ϩ ] i overload is always associated with myocardial injury upon IR. In support of the notion, a host of experimental studies have shown that calcium channel antagonists limited the infarct size induced by IR (Przyklenk et al., 1999). In a recent study, we found that administration of a c...