Abstract-Chronic stimulation of the -adrenergic neurohormonal axis contributes to the progression of heart failure and mortality in animal models and human patients. In cardiomyocytes, activation of the -adrenergic pathway has been shown to result in transiently increased expression of a cardiac small heat-shock protein Hsp20. The present study shows that cardiac overexpression (10-fold) of Hsp20 may protect the heart against -agonist-induced cardiac remodeling, associated with isoproterenol (50 g/g per day) infusion for 14 days. Hsp20 attenuated the cardiac hypertrophic response, markedly reduced interstitial fibrosis, and decreased apoptosis. Contractility was also preserved in hearts with increased Hsp20 levels. These beneficial effects were associated with attenuation of the ASK1-JNK/p38 (apoptosis signal-regulating kinase 1/c-Jun NH 2 -terminal kinase/p38) signaling cascade triggered by isoproterenol, whereas there was no difference in either extracellular signal-related kinase 1/2 or Akt activation. Parallel in vitro experiments supported the inhibitory role of Hsp20 on enforced ASK1-JNK/p38 activation in both H9c2 cells and adult rat cardiomyocytes. Immunostaining studies also demonstrated that Hsp20 colocalizes with ASK1 in cardiomyocytes. Taken together, our findings indicate that (1) -agonist-induced cardiac injury is associated with activation of the ASK1-JNK/p38 cascade; (2) increased expression of Hsp20 attenuates the induction of remodeling, dysfunction, and apoptosis in response to sustained -adrenergic stimulation; and (3) A poptosis signal-regulating kinase 1 (ASK1) is a ubiquitously expressed mitogen-activated protein kinase (MAPK) kinase kinase (MAPKKK), which activates the c-Jun NH 2 -terminal kinase (JNK) (also known as stress-activated protein kinase [SAPK]) and p38 MAPK signaling cascades. 1 Overexpression of wild-type (WT) or constitutively active ASK1 induced apoptosis in isolated rat neonatal cardiomyocytes, whereas rat neonatal ASK1-deficient cardiomyocytes were resistant to H 2 O 2 -induced apoptosis. 2 Recent studies have indicated that ablation of ASK1 was associated with (1) inhibition of angiotensin II-and G protein-coupled receptor (GPCR) agonist-induced heart dysfunction and dilatation 3,4 ; (2) attenuation of cardiac remodeling mediated by myocardial infarction and pressure overload 2 ; and (3) rescue of Raf-1 knockout-induced cardiac dysfunction and apoptosis. 5 These observations suggest that inhibition of ASK1 may be a promising target for prevention of cardiac remodeling and, thus, suppression of heart failure onset and progression.Heart failure is characterized by enhanced adrenergic stimulation to correct systolic and diastolic dysfunction, but chronic elevation of sympathetic drive can exert deleterious effects on the myocardium, promoting the development of fibrotic cardiomyopathy. 6,7 The mechanisms underlying the transition between the contractile benefits and the maladaptive processing, including cell death, are still heavily debated. 8,9 The MAPKs, mainly incl...