During pressure overload, APN deficiency accelerated the transition from cardiac hypertrophy to heart failure20 and cardiac fibrosis36, but pretreatment with recombinant APN significantly decreased H2O2-induced cardiomyocyte hypertrophy by decreasing total protein levels, protein synthesis, and atrial natriuretic factor and brain natriuretic peptide expression36. The gene discussed is NPPB; the disease is cardiac hypertrophy.