Although cardiac hypertrophy has been the subject of intensive investigation, regression of hypertrophy has been significantly less studied, precluding large-scale analysis of the relationship between these processes. In the present study, using pharmacological models of cardiac hypertrophy in mice, expression profiling was performed with fragments of more than 4,000 genes to characterize and contrast expression changes during induction and regression of hypertrophy. Administration of angiotensin II and isoproterenol by osmotic minipump produced increases in heart weight (15 and 45%, respectively) that returned to preinduction size after drug withdrawal. From multiple expression analyses of left ventricular RNA isolated at daily time-points during cardiac hypertrophy and regression, we identified sets of genes whose expression was altered at specific stages of this process. While confirming the participation of 25 genes or pathways previously shown to be altered by hypertrophy, a larger set of 30 genes was identified whose expression had not previously been associated with cardiac hypertrophy or regression. Of the 55 genes that showed reproducible changes during the time course of induction and regression, 32 genes were altered only during induction, and 8 were altered only during regression. This study identified both known and novel genes whose expression is affected at different stages of cardiac hypertrophy and regression and demonstrates that cardiac remodeling during regression utilizes a set of genes that are distinct from those used during induction of hypertrophy.T he heart increases its muscle mass in response to increased wall stress resulting from physiologic or pathologic states. The most characteristic cellular feature of this process is the enlargement of existing myocytes caused by the accumulation of sarcomeric proteins and reorganization of myofibrillar structures. Although this response is initially compensatory, it may progress to a pathologic state. As a result, cardiac hypertrophy is a predictor of cardiac morbidity and mortality, independent of hypertension or other risk factors (1, 2).Analysis of gene expression during the induction of cardiac hypertrophy has revealed a specific transcriptional pattern associated with this process. Early mediators of the hypertrophic transcriptional program include the immediate-early genes (e.g., c-fos, c-myc, c-jun, and Egr1), followed by a cascade of mitogen-activated protein kinases (3-7). These changes contribute to substantial alterations in the expression and organization of sarcomeric and structural proteins (3,8).In contrast to the numerous studies examining the response to induction of hypertrophy, surprisingly few studies have examined genes whose expression is specifically altered during recovery from cardiac hypertrophy. The few studies that have examined gene expression changes during regression have largely focused on a small number of reporter genes such as myosin heavy chain (9, 10) and have not sought to identify new genes expressed spec...