Abstract-We have examined how different degrees (0.5%, 1.0%, 2.5%, 5.0%, and 10.0%) and directions of stretch regulate the turnover and accumulation of contractile proteins in cultured neonatal cardiac myocytes (NCMs). In pulse-chase experiments, stellate-shaped NCMs with random arrays of myofibrils (MFs) exhibited a threshold response to stretch. With respect to unstretched controls, the turnover of the contractile protein pool was suppressed 50% to 100% in stellate NCMs stretched 1.0% to 5.0% and was unaltered in stellate NCMs stretched 0.5% or 10.0%. The posttranslational metabolism of myosin heavy chain (MHC) and actin was regulated in parallel with the total contractile protein pool. The turnover of the cytoplasmic protein pool remained unchanged in response to stretch. NCMs plated onto an aligned matrix of type I collagen expressed an elongated, rod-like cell shape. The MFs of these cells were distributed in parallel with one another along a single unique axis. The tissue-like pattern of organization of these cultures made it possible to assay how specific directions of stretch affected cardiac protein turnover and MF organization. In pulse-chase experiments, stretch in parallel with the MFs did not alter the turnover of the total contractile protein pool, the cytoplasmic protein pool, MHC, or actin. The total cellular concentration of MHC and actin remained constant, and MF alignment was not overtly affected. In contrast, even modest degrees of stretch across the short axis of the MFs suppressed total contractile protein turnover, the turnover of MHC and actin, and promoted the accumulation of these MF subunits. The parallel alignment of MFs deteriorated in myocytes stretched greater than 5%. The characteristic response of aligned myocytes to stretch was not affected by the contractile state of the cells. Key Words: stretch Ⅲ myofibril Ⅲ hypertrophy T he intact myocardium is composed of a complex array of muscle cells that are distributed in a series of discrete, overlapping cellular layers. Within each cell layer, the rodlike myocytes of the heart are distributed in parallel with one another along a common axis. In the subendocardium and subepicardium of the left ventricle, the myocytes are arranged in a longitudinal orientation that is in parallel with the long axis of the heart. 1 The muscle cells of the midwall radiate in a circumferential pattern around the ventricular lumen and are oriented Ϸ90°off-axis with respect to the more superficial and deep cell layers. 2 Adjacent cell layers are interconnected and tethered to one another by an elaborate network of collagen fibrils. 3 As a result of the intricate organization of the intact heart, cardiac myocytes are subjected to a very complex set of mechanical forces during the contractile cycle. For example, in working hearts, the axis of shortening during contraction varies considerably less than the local myofiber direction. 2,4,5 The data from these experiments indicate that any given local population of myocytes may be exposed to a unique combination ...