We have investigated whether the myocardium and isolated cardiac myocytes can express a Ca²⁺‐independent NO synthase after treatment with endotoxin or cytokines. Nitric oxide synthesis was measured in cytosols from the left ventricular wall from rats treated with endotoxin, or from freshly isolated myocytes from adult rats treated in vitro with cytokines.

Cytosols from the ventricle of saline‐treated control animals showed only Ca²⁺‐dependent NO synthesis. After treatment with endotoxin, the expression of an inducible, Ca²⁺‐independent NO synthase was observed. The activity of this enzyme was maximal at 6 h and returned towards control levels by 18 h; no alterations occurred in the Ca²⁺‐dependent NO synthase activity. Parallel to this enzyme induction there was an increase in myocardial guanosine 3′:5′‐cyclic monophosphate (cyclic GMP) and plasma nitrite and nitrate (NO⁻_x). All these changes were prevented by pretreatment of the rats with dexamethasone.

Myocytes possessed Ca²⁺‐dependent NO synthase activity and expressed, after treatment with tumour necrosis factor‐α (TNF‐α) and interleukin‐1β (IL‐1β), a Ca²⁺‐independent NO synthase, the induction of which was prevented by dexamethasone and cycloheximide.

Since increases in cyclic GMP levels in the heart are associated with reduced myocardial contractility, it is possible that the enhanced production of NO by a Ca²⁺‐independent enzyme accounts, at least in part, for the depression of myocardial contractility seen in septic shock, cardiomyopathies, allograft rejection, burn trauma, as well as during anti‐tumour therapy with cytokines.