Rho-associated coiled-coil protein kinase 1 (ROCK-1) is a direct cleavage substrate of activated caspase-3, which is associated with heart failure. In the course of human heart failure, we found marked cleavage of ROCK-1 resulting in a 130-kDa subspecies, which was absent in normal hearts and in an equivalent cohort of patients with left ventricular assist devices. Murine cardiomyocytes treated with doxorubicin led to enhanced ROCK-1 cleavage and apoptosis, all of which was blocked by a caspase-3 inhibitor. In addition, a bitransgenic mouse model of severe cardiomyopathy, which overexpresses Gq protein and hematopoietic progenitor kinase-͞germinal center kinase-like kinase, revealed the robust accumulation of the 130-kDa ROCK-1 cleaved fragment. This constitutively active ROCK-1 subspecies, when expressed in cardiomyocytes, led to caspase-3 activation, indicating a positive feedforward regulatory loop. ROCK-1-dependent caspase-3 activation was coupled with the activation of PTEN and the subsequent inhibition of protein kinase B (Akt) activity, all of which was attenuated by siRNA directed against ROCK-1 expression. Similarly, ROCK-1-null mice (Rock-1 ؊/؊ ) showed a marked reduction in myocyte apoptosis associated with pressure overload. These data suggest an obligatory role for ROCK-1 cleavage in promoting apoptotic signals in myocardial hypertrophy and͞or failure.heart failure ͉ left ventricle assist device ͉ phosphatase and tensin homolog deleted on chromosome ten H eart failure is an eventual outcome for diverse cardiovascular disorders and the leading cause of combined morbidity and mortality in the United States and other developed industrial nations (1). Diverse signal transduction pathways, G proteins and protein kinases among them, likely contribute to heart failure, and the identification of essential control points have both fundamental and translational importance (2, 3). Recent findings suggest a role for the activation of the apoptotic cascade in heart failure, which may involve the activation of proteolytic caspase-3 and cardiomyocyte loss (1, 4). Although the level of apoptosis detected in the failing heart are variable (4-6), a low prevalence of apoptosis is sufficient to cause cardiac contractile depression (7). Accounting for the most conservative rate of cardiomyocyte death, the normal heart would lose most of its mass in a few decades, but the senile and failing heart lose myocytes in a matter of several months to a few years (8). This dilemma raised the issue of the imbalance between the continual loss of cardiomyocytes and the long interval for the chronic progression in heart failure. There are critical deficiencies in the available information regarding the relationship between apoptosis in the failing heart and depressed contractile function. Other mechanisms might contribute to heart failure besides cell loss. For example, we showed that activated caspase-3 mediated the cleavage of serum response factor (SRF). Cleaved SRF became a dominant negative factor that down-regulated SRF target ...