The role of Ca2+ in the manifestation of the cardioprotective effect of phosphocreatine (PCr) on the ischemic myocardium was studied in isolated rat hearts perfused by the Langendorf method. Under ischemic cardiac arrest induced by a Ca(2+)-free perfusing solution PCr had no protective effect on the ischemic myocardium. PCr accelerated the postischemic restoration of contractility of hearts perfused with a solution containing 0.5 and 1.2 mM Ca2+. The structural analog of PCr, phosphoarginine, possessing a Ca(2+)-binding capacity similar to that of PCr, had no protective effect. The effects of PCr and Ca2+ on the package of sarcolemmal vesiculate lipids were studied by ESR spectroscopy. PCr induced a more dense package of membrane phospholipids at weakly acidic and neutral values of pH (but not at pH 8.5). Although at pH 5.5 Ca2+ did not affect the membrane structure, it potentiated the effect of PCr on sarcolemmal phospholipids. Thus, the protective effect of PCr on the ischemic myocardium is not linked with its ability to bind Ca2+; however, Ca2+ is an indispensable component of the mechanism underlying the protective effect of PCr on the ischemic myocardium.