1. To assess the involvement of volume overload in the development of cardiac hypertrophy during treatment with an antidiabetic thiazolidinedione, changes in cardiac anatomy and parameters of cardiac volume overload were evaluated in female Sprague‐Dawley rats treated with the thiazolidinedione derivative T‐174.

2. Two week administration of T‐174 (13 and 114 mg/kg per day) increased absolute and relative heart weights by 11–24%, demonstrating the development of cardiac hypertrophy. There was no evidence of oedema in hearts from treated rats.

3. Both plasma and blood volumes were increased in T‐174‐treated rats without any changes in systolic blood pressure and heart rate, whereas haematocrit was decreased. In accordance with the existence of volume overload, both left ventricular end‐diastolic pressure and right atrial pressure were increased. Morphometric analysis of hearts revealed that T‐174 induced eccentric heart hypertrophy, as characterized by a small increase in wall thickness and a large increase in the chamber volume, which is characteristic of volume overload. Volume overload is suggested as the possible trigger mechanism because blood volume expansion preceded cardiac hypertrophy and there was a high correlation between heart weight and blood volume.

4. T‐174‐treated streptozotocin‐induced diabetic rats also exhibited blood volume expansion and cardiac hypertrophy.

5. These findings suggest that cardiac volume overload is induced by plasma volume expansion and contributes to the development of eccentric cardiac hypertrophy during treatment with antidiabetic thiazolidinediones. Although thiazolidinediones are insulin‐sensitizing agents, these cardiac effects are likely to be mediated independently of insulin.