Popov S, Venetsanou K, Chedrese PJ, Pinto V, Takemori H, Franco-Cereceda A, Eriksson P, Mochizuki N, Soares-da-Silva P, Bertorello AM. Increases in intracellular sodium activate transcription and gene expression via the salt-inducible kinase 1 network in an atrial myocyte cell line. Am J Physiol Heart Circ Physiol 303: H57-H65, 2012. First published March 30, 2012 doi:10.1152/ajpheart.00512.2011.-Cardiac hypertrophy (CH) generally occurs as the result of the sustained mechanical stress caused by elevated systemic arterial blood pressure (BP). However, in animal models, elevated salt intake is associated with CH even in the absence of significant increases in BP. We hypothesize that CH is not exclusively the consequence of mechanical stress but also of other factors associated with elevated BP such as abnormal cell sodium homeostasis. We examined the effect of small increases in intracellular sodium concentration ([Na ϩ ]i) on transcription factors and genes associated with CH in a cardiac cell line. Increases in [Na ϩ ]i led to a timedependent increase in the expression levels of mRNA for natriuretic peptide and myosin heavy chain genes and also increased myocyte enhancer factor (MEF)2/nuclear factor of activated T cell (NFAT) transcriptional activity. Increases in [Na ϩ ]i are associated with activation of salt-inducible kinase 1 (snflk-1, SIK1), a kinase known to be critical for cardiac development. Moreover, increases in [Na ϩ ]i resulted in increased SIK1 expression. Sodium did not increase MEF2/ NFAT activity or gene expression in cells expressing a SIK1 that lacked kinase activity. The mechanism by which SIK1 activated MEF2 involved phosphorylation of HDAC5. Increases in [Na ϩ ]i activate SIK1 and MEF2 via a parallel increase in intracellular calcium through the reverse mode of Na ϩ /Ca 2ϩ -exchanger and activation of CaMK1. These data obtained in a cardiac cell line suggest that increases in intracellular sodium could influence myocardial growth by controlling transcriptional activation and gene expression throughout the activation of the SIK1 network.hypertension; cardiac hypertrophy; Na ϩ ,K ϩ -ATPase; ion gradients CARDIAC HYPERTROPHY IS CONSIDERED to be the heart's response to sustained mechanical stress caused by either obstruction of cardiac outflow (valve stenosis) or elevated systemic arterial blood pressure. At the molecular level, its development involves the activation of numerous genes and transcription factors (9, 18, 30) that ultimately lead to abnormal myocardial growth. Hypertension is presently one of the major causes of cardiac hypertrophy. Although systemic hypertension has multiple causes, it ultimately results from the kidney's inability to maintain sodium homeostasis after normal or excessive sodium intake (1, 16). Whereas a sustained increase in systemic blood pressure is likely to influence the development of cardiac hypertrophy, it has also been demonstrated that high salt intake is associated with left ventricle hypertrophy even without significant increases in systemic blood pr...