Cardiomyocytes grow in hypertrophy due to a net increase in the synthesis of proteins, especially contractile proteins, in the cell. There is abundant information about the molecular and biochemical changes involved in this process, but it is not completely understood how cells sense mechanical stimuli and how these stimuli are transferred into a biochemical signal inducing the growth response. This mechanotransduction most likely takes place at the cellular membrane. The resulting signal is transferred to the nucleus, where it can initiate alterations in gene expression.