After certain periods of myocardial ischemia and reperfusion, cardiac dysfunction exists in the absence of myonecrosis. In a blood-perfused isolated rat heart model, we have demonstrated early gene changes that are associated with global myocardial "stunning." Early gene changes included elevations in the expression of messenger RNAs for HSP70, c-myc and c-fos. Increased expression of messenger RNAs for protooncogenes is an important observation because of the role of protooncogenes as nuclear transcription factors. From these study findings, it would appear that the stunning state is associated with early gene changes that may signal the induction of a hypertrophic process. Subsequent studies are required to demonstrate the exact events which take place in the course of stunning that directly initiate an alteration in gene expression.