Excess ROS production contributed to nicotine induced autophagy impairment and cardiomyocytes hypertrophy through activation of p38MAPK and JNK and cilostazol decreased ROS level elevated by nicotine. (A) ROS levels were determined by using DCFH-DA probe, NAC decreased ROS significantly as positive control (Scale bar=20μm). (B) NAC pretreatment inhibited effects of nicotine on autophagy. Quantitative analysis of (C) LC3-II and (D) p62 in figure B. (E) Real-time PCR-based quantitation of cardiac hypertrophy markers. (F) Cilostazol pretreatment inhibited nicotine induced ROS accumulation (Scale bar=20 μm) (****, p < 0.0001; ***, p < 0.001; **, p < 0.01; *, p < 0.05, n = 3).