The mammalian Na ؉ /Ca 2؉ exchanger, NCX1.1, serves as the main mechanism for Ca 2؉ efflux across the sarcolemma following cardiac contraction. In addition to transporting Ca 2؉ , NCX1.1 activity is also strongly regulated by Ca 2؉ binding to two intracellular regulatory domains, CBD1 and CBD2. The structures of both of these domains have been solved by NMR spectroscopy and x-ray crystallography, greatly enhancing our understanding of Ca 2؉ regulation. Nevertheless, the mechanisms by which Ca 2؉ regulates the exchanger remain incompletely understood. -ATPase) and expulsion from the cell (primarily through the Na ϩ /Ca 2ϩ exchanger, NCX1.1) results in relaxation (1). Altered Ca 2ϩ cycling is observed in a number of pathophysiological situations including ischemia, hypertrophy, and heart failure (2). Understanding the function and regulation of NCX1.1 is thus of fundamental importance to understand cardiac physiology.NCX1.1 utilizes the electrochemical potential of the Na ϩ gradient to extrude Ca 2ϩ in a ratio of three Na ϩ ions to one Ca 2ϩ ion (3). In addition to transporting both Na ϩ and Ca 2ϩ , NCX1.1 is also strongly regulated by these two ions. Intracellular Na ϩ can induce NCX1.1 to enter an inactivated state, whereas Ca 2ϩ bound to regulatory sites removes Na ϩ -dependent inactivation and also activates Na ϩ /Ca 2ϩ exchange (3). These regulatory sites are located on a large cytoplasmic loop (ϳ500 residues located between transmembrane helices V and VI) containing two calcium binding domains (CBD1 and CBD2), which sense cytosolic Ca 2ϩ levels. We have previously shown that Ca 2ϩ binding to the primary site in CBD2 is required for full exchange regulation (4); CBD1, however, is a site of higher affinity and appears to dominate the activation of exchange activity by Ca 2ϩ . Both CBDs have an immunoglobulin fold formed from two antiparallel  sheets generating a  sandwich with a differing number of Ca 2ϩ ions coordinated at the tip of the domain (4, 5). CBD1 binds four Ca 2ϩ ions, whereas CBD2 binds only two Ca 2ϩ ions. An initial NMR study revealed a local unfolding of the upper portion of CBD1 upon release of Ca 2ϩ (6). In contrast, CBD2 did not display an unfolding response upon Ca 2ϩ removal. A comparative analysis between CBDs revealed a difference in charge at residues in equivalent positions near the Ca 2ϩ coordination site; Glu-454 in CBD1 is replaced by Lys-585 in CBD2. The unstructuring of CBD1 upon Ca 2ϩ removal was alleviated by reversing the charge of the acidic residue (E454K) involved in Ca 2ϩ coordination (6). Previously, we solved the structures of the Ca 2ϩ -bound and -free conformations of CBD2 and revealed a charge compensation mechanism involving Lys-585 (4). The positively charged lysine residue assumes the position of one of the Ca 2ϩ ions upon Ca 2ϩ depletion, permitting CBD2 to retain its overall fold (4). A similar phenomenon is predicted to take place in E454K-CBD1 mutant. In addition, Hilge et al. (6) showed that the E454K mutation of CBD1 decreases Ca 2ϩ affinity to a level simi...