Abstract-We established previously that 5-HT 2B receptors are involved in cardiac hypertrophy through the regulation of hypertrophic cytokines in cardiac fibroblasts. Moreover, the generation of reactive oxygen species and tumor necrosis factor-␣ through the activation of reduced nicotinamide-adenine dinucleotide phosphate [NAD(P)H] oxidase has been implicated in cardiac hypertrophy. In this study, we investigated whether 5-HT 2B receptors could be involved in the development of cardiac hypertrophy associated with superoxide anion production. Therefore, we measured the effects of serotonergic 5-HT 2B receptor blockade on left-ventricular superoxide anion generation in 2 established pharmacological models of cardiac hypertrophy, ie, angiotensin II and isoproterenol infusions in mice. Angiotensin II infusion for 14 days increased superoxide anion concentration (ϩ32%), NAD(P)H oxidase maximal activity (ϩ84%), and p47 phox NAD(P)H oxidase subunit expression in the left ventricle together with hypertension (ϩ37 mm Hg) and cardiac hypertrophy (ϩ17% for heart weight:body weight). The 5-HT 2B receptor blockade by a selective antagonist (SB215505) prevented the increase in cardiac superoxide generation and hypertrophy. Similarly, infusion for 5 days of isoproterenol increased left-ventricular NAD(P)H oxidase activity (ϩ48%) and cardiac hypertrophy (ϩ31%) that were prevented by the 5-HT 2B receptor blockade. Finally, in the primary culture of left-ventricular cardiac fibroblasts, angiotensin II and isoproterenol stimulated NAD(P)H oxidase activity. This activation was prevented by SB215505. These findings suggest that the 5-HT 2B receptor may represent a new target to reduce cardiac hypertrophy and oxidative stress. Its blockade affects both angiotensin II and -adrenergic trophic responses without significant hemodynamic alteration. Key Words: 5-HT 2B Ⅲ NAD(P)H oxidase Ⅲ superoxide anion Ⅲ angiotensin Ⅲ adrenergic Ⅲ cardiac Ⅲ hypertrophy P athological left ventricular hypertrophy has been associated with increased production of reactive oxygen species (ROS). Recent works have shown that antioxidants inhibit in vitro cardiomyocyte hypertrophy and in vivo aortic bandinginduced left ventricular hypertrophy. 1 The cardiac ROS production can be triggered by factors such as angiotensin II (Ang II), catecholamines, endothelin-1, tumor necrosis factor-␣ (TNF-␣), and serotonin but also by mechanical stretch. Among these factors, those that signal through the G q /PLC pathway seem to play a crucial role in the initiation and maintenance of cardiac hypertrophy and are known to stimulate the cardiac ROS generation through the phagocytetype reduced nicotinamide-adenine dinucleotide phosphate [NAD(P)H] oxidase. 2 The gp91 phox -containing NAD(P)H oxidase plays a pivotal role in the response to Ang II via a pathway involving protein kinase C, c-Src, and phosphatidylinositol 3-kinase. 3 NAD(P)H oxidase reduces oxygen O 2 , leading to the formation of superoxide anion (O 2 ⅐Ϫ ), which can be either dismutated spontaneously to hydrogen pe...