PRKG1 and cardiac hypertrophy: These pathways further influence change in gene transcription that leads to changes in protein synthesis, which leads to cardiac hypertrophy [50]. One of the first to provide molecular insight on how extracellular signals travel from cell membrane to nucleus is the calcineurin/nuclear factor of the activated T-cell (NFAT) pathway [51]. It is well understood that a significant downstream effector of cyclic guanosine monophosphate (cGMP) signaling in cardiomyocytes is cGMP-dependent protein kinase-1 (PKG-1).