NPPA and cardiac hypertrophy: The TMAO treatment induced the hypertrophy of cultured cardiomyocytes and expression of hypertrophic markers such as atrial natriuretic peptide (ANP) and beta-myosin heavy chain (β-MHC) that was demonstrated to be mediated via TGF-β/Smad3 signaling that had been identified in the development of cardiac hypertrophy and fibrosis.