Abstract-The use of antagonists of the mineralocorticoid receptor in the treatment of myocardial hypertrophy and heart failure has gained increasing importance in the last years. The cardiac Na ϩ /H ϩ exchanger (NHE-1) upregulation induced by aldosterone could account for the genesis of these pathologies. We tested whether aldosterone-induced NHE-1 stimulation involves the transactivation of the epidermal growth factor receptor (EGFR). Rat ventricular myocytes were used to measure intracellular pH with epifluorescence. Aldosterone enhanced the NHE-1 activity. This effect was canceled by spironolactone or eplerenone (mineralocorticoid receptor antagonists), but not by mifepristone (glucocorticoid receptor antagonist) or cycloheximide (protein synthesis inhibitor), indicating that the mechanism is mediated by the mineralocorticoid receptor triggering nongenomic pathways. Aldosterone-induced NHE-1 stimulation was abolished by the EGFR kinase inhibitor AG1478, suggesting that is mediated by transactivation of EGFR. The increase in the phosphorylation level of the kinase p90 RSK and NHE-1 serine703 induced by aldosterone was also blocked by AG1478. Exogenous epidermal growth factor mimicked the effects of aldosterone on NHE-1 activity. Epidermal growth factor was also able to increase reactive oxygen species production, and the epidermal growth factor-induced activation of the NHE-1 was abrogated by the reactive oxygen species scavenger N-2-mercaptopropionyl glycine, indicating that reactive oxygen species are participating as signaling molecules in this mechanism. Aldosterone enhances the NHE-1 activity via transactivation of the EGFR, formation of reactive oxygen species, and phosphorylation of the exchanger. These results call attention to the consideration of the EGFR as a new potential therapeutic target of the cardiovascular pathologies involving the participation of aldosterone. [1][2][3][4] Aldosterone has been shown to induce left ventricular hypertrophy independently from its classic effects on regulation of renal Na ϩ and blood pressure. 5-7 However, the cellular, subcellular, and molecular bases for this effect are not yet understood. Fujisawa et al 8 demonstrated that the mineralocorticoid/salt-induced rat cardiac fibrosis and hypertrophy were prevented by the selective Na ϩ /H ϩ exchanger (NHE-1) blocker cariporide. It has also been reported that aldosterone upregulates the expression and function of the NHE-1 9 -12 and that selective blockade of this transporter prevents and/or reverts left ventricular hypertrophy in various animal models. 13 Therefore, we focused our attention on the intracellular pathway that involves aldosterone and NHE-1 as trigger and end point target, respectively.Steroids, including aldosterone, are able to interact with peptide hormone signaling. The epidermal growth factor (EGF) and its receptor (EGFR) represent one of these signals involving aldosterone. 14,15 It has been shown that spironolactone reduces the EGFR mRNA synthesis after cerebral ischemia. 16 Accordingly, Gross...