Synd4 overexpression induced cultured cardiomyocyte hypertrophy. Ad-synd4 was used to activate synd4. Ad-Lacz was used as control. IGF-1 (10 nmol/L) and ISO (10 μm) were added to Ad-Lacz transfected cells to induce typical physiological and pathological cell hypertrophy respectively. (A) Immunofluorescence assay showed increased cell area in synd4-overexpressed, IGF-1-treated and ISO-treated cardiomyocytes. *P < 0.05, Ad-synd4 versus Ad-Lacz, Ad-Lacz + IGF-1 versus Ad-Lacz, Ad-Lacz + ISO versus Ad-Lacz; scale bar = 20 μm; N = 3 experiments, ANOVA. (B) (35S)methionine incorporation assay showed increased protein production in synd4-overexpressed, IGF-1-treated and ISO-treated cardiomyocytes. *P < 0.05, Ad-synd4 versus Ad-Lacz, Ad-Lacz + IGF-1 versus Ad-Lacz, Ad-Lacz + ISO versus Ad-Lacz; N = 3 experiments, ANOVA. (C) Tunel assay showed increase in tunel-positive cells in ISO-treated cardiomyocytes. #P < 0.05, Ad-synd4 versus Ad-Lacz + ISO, Ad-Lacz + IGF-1 versus Ad-Lacz + ISO, Ad-Lac versus Ad-Lacz + ISO; scale bar = 50 μm; N = 3 experiments, ANOVA.