Regulation of the cardiac Na+/H+ exchanger in health and disease

► Stimulation of hormone receptor activates the sarcolemmal NHE1. ► Activation of NHE1 leads to increase in intracellular pH and Na+ concentration. ► Ionic changes via NHE1 can initiate cardiac hypertrophy and heart failure. ► We discuss upstream and downstream signaling pathways of NHE1.