profiling of left ventricle eccentric hypertrophy in aortic regurgitation in rats: rationale for targeting the -adrenergic and renin-angiotensin systems. Am J Physiol Heart Circ Physiol 296: H669 -H677, 2009. First published December 26, 2008 doi:10.1152/ajpheart.01046.2008.-Aortic valve regurgitation (AR) imposes a severe volume overload to the left ventricle (LV), which results in dilation, eccentric hypertrophy, and eventually loss of function. Little is known about the impact of AR on LV gene expression. We, therefore, conducted a gene expression profiling study in the LV of rats with acute and severe AR. We identified 64 genes that were specifically upregulated and 29 that were downregulated out of 21,910 genes after 2 wk. Of the upregulated genes, a good proportion was related to the extracellular matrix. We subsequently studied a subset of 19 genes by quantitative RT-PCR (qRT-PCR) to see if the modulation seen in the LV after 2 wk persisted in the chronic phase (after 6 and 12 mo) and found that it did persist. Knowing that the adrenergic and renin-angiotensin systems are overactivated in our animal model, we were interested to see if blocking those systems using metoprolol (25 mg ⅐ kg Ϫ1 ⅐ day Ϫ1 ) and captopril (100 mg ⅐ kg Ϫ1 ⅐ day Ϫ1 ) would alter the expression of some upregulated LV genes in AR rats after 6 mo. By qRT-PCR, we observed that upregulations of LV mRNA levels encoding for procollagens type I and III, fibronectin, atrial natriuretic peptide, transforming growth factor-2, and connective tissue growth factor were totally or partially reversed by this treatment. These observations provide a molecular rationale for a medical strategy aiming these systems in the medical treatment of AR and expand the paradigm in the study of this form of LV volume overload. heart hypertrophy; gene expression; renin-angiotensin system; adrenergic system SEVERE AORTIC VALVE REGURGITATION (AR) is associated with a long asymptomatic period during which the left ventricle (LV) progressively dilates and hypertrophies in response to a chronic volume overload. This process is accompanied by a decrease in LV function, occurrence of symptoms, and eventually heart failure (4, 7). No drug has yet been clearly shown in humans to be effective to slow LV dilation, hypertrophy, and loss of systolic function or to have any impact on morbidity or mortality in chronic AR (5, 15).At the microscopic level, AR is associated with cardiomyocyte elongation and excessive but mostly noncollagen myocardial fibrosis (fibronectin) (6, 23). Although gene expression profiling in LV eccentric hypertrophy resulting from volume overload has been studied recently in an aortocaval fistula rat model (25), very little is known about the mechanisms of LV hypertrophy and extracellular matrix (ECM) remodeling associated with a more clinically common form of LV volume overload, namely AR. Aortocaval fistula models relate to a clinically rather rare complication of aortic aneurysm or secondary to abdominal trauma in humans (21). Moreover, aortocaval ...