The temporal myocardial remodeling induced by chronic ventricular volume overload in male rats was examined. Specifically, left ventricular (LV) cardiomyocyte length and width, sarcomere length, and number of nuclei were measured in male rats (n ؍ 8 to 17) at 1, 3, 5, 7, 21, 35, and 56 days after creation of an infrarenal aortocaval fistula. In contrast to previously published reports of progressive increases in cardiomyocyte length and cross-sectional area at 5 days post-fistula and beyond in female hearts, cardiomyocyte length and width did not increase significantly in males during the first 35 days of volume overload. Furthermore, a significant decrease in cardiomyocyte length relative to age-matched controls, together with a reduced number of sarcomeres per cell, was noted in male hearts at 5 days post-fistula. There was a concurrent increase in the percentage of mononucleated cardiomyocytes from 11.6% to 18% at 5 days post-fistula. These initial differences could not be attributed to cardiomyocyte proliferation, and treatment with a microtubule stabilizing agent prevented them from occurring. The subsequent significant increase in LV weight without corresponding increases in cardiomyocyte dimensions is indicative of hyperplasia. Thus, these findings indicate hyperplasia resulting from cytokinesis of cardiomyocytes is a key mechanism, independent of hypertrophy, that contributes to the significant increase in LV mass in male hearts subjected to chronic volume overload. The myocardium is remodeled in response to a sustained increase in stress and/or injury in an effort to normalize myocardial wall stress.1 This compensatory process is typically progressive and involves all components of the myocardium. Depending on the nature of the stress, cardiomyocyte remodeling involves the parallel and/or inseries addition of sarcomeres, resulting in myocyte thickening and/or lengthening, respectively.2 In response to ventricular volume overload induced secondary to an aortocaval fistula, Liu et al 3,4 reported progressive, temporally proportional increases in cardiomyocyte length and cross-sectional area in female rats. However, our recent studies have found gender differences in the pattern of global myocardial remodeling, in which males develop eccentric hypertrophy and heart failure in response to a sustained ventricular volume overload, whereas the female heart is cardioprotected, developing concentric hypertrophy and remaining compensated. [5][6][7][8][9] These observations raise the obvious question-does this difference in the pattern of remodeling exist at the level of the cardiomyocyte as well? Thus, the purpose of this study was to determine whether temporal differences in cardiomyocyte size and structure contribute to adverse remodeling occurring in male hearts subjected to a sustained volume overload and compare those findings with that previously reported for female rats. 3,4 To this end, we examined isolated cardiomyocytes from adult, male rats at discrete times over an 8-week period of chronic volume ov...