Activation of Ca2؉ signaling induced by receptor stimulation and mechanical stress plays a critical role in the development of cardiac hypertrophy. A canonical transient receptor potential protein subfamily member, TRPC6, which is activated by diacylglycerol and mechanical stretch, works as an upstream regulator of the Ca 2؉ signaling pathway. Although activation of protein kinase G (PKG) inhibits TRPC6 channel activity and cardiac hypertrophy, respectively, it is unclear whether PKG suppresses cardiac hypertrophy through inhibition of TRPC6. Here, we show that inhibition of cGMP-selective PDE5 (phosphodiesterase 5) suppresses endothelin-1-, diacylglycerol analog-, and mechanical stretch-induced hypertrophy through inhibition of Ca 2؉ influx in rat neonatal cardiomyocytes. influx. Substitution of Ala for Thr 69 in TRPC6 abolished the anti-hypertrophic effects of PDE5 inhibition. In addition, chronic PDE5 inhibition by oral sildenafil treatment actually induced TRPC6 phosphorylation in mouse hearts. Knockdown of RGS2 (regulator of G protein signaling 2) and RGS4, both of which are activated by PKG to reduce G␣ q -mediated signaling, did not affect the suppression of receptor-activated Ca 2؉ influx by PDE5 inhibition. These results suggest that phosphorylation and functional suppression of TRPC6 underlie prevention of pathological hypertrophy by PDE5 inhibition.Pathological hypertrophy of the heart, induced by pressure overload, such as chronic hypertension and aortic stenosis, is a major risk factor for heart failure and cardiovascular mortality (1). Neurohumoral factors, such as norepinephrine, angiotensin II (Ang II), 2 and endothelin-1 (ET-1), and mechanical stress are believed to be prominent contributors for pressure overloadinduced cardiac hypertrophy (2, (9). A partial depolarization of plasma membrane by receptor stimulation is reported to increase the frequency of Ca 2ϩ oscillations, leading to activation of nuclear factor of activated T cells (NFAT), a transcription factor that is predominantly regulated by calcineurin (10). Recent reports have indicated that transient receptor potential canonical (TRPC) subfamily proteins play an essential role in agonistinduced membrane depolarization (11, 12). The relevance of TRPC channels to pathological hypertrophy is underscored by the observations that heart-targeted transgenic mice expressing TRPC channels caused hypertrophy (13,14) and that TRPC proteins were up-regulated in hypertrophied and failing hearts (14 -17). Among seven TRPC subfamilies, increased channel activities of TRPC1, TRPC3, and TRPC6 have been implicated in cardiac hypertrophy in vivo. TRPC1 is known to function not * This study was supported by grants from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (to M. Nishida, M. Nakaya, and H. Kurose), a grant-in-aid for scientific research on Innovative Areas (to M. Nishida), a grant-in-aid for scientific research on Priority Areas (H. Kurose), and grants from the Naito Foundation, the Nakatomi Foundation, the Sapporo ...