Most of the things remain quite similar. There was some cleanup, but the basics (signal-slot mechanism for example) remain the same. You still have all those QStrings, QActions, QDialogs etc. Your Qt3 knowledge should remain valuable.
On the other hand there are many new elements. There's a big QGraphicsView framework, Phonon framework for multimedia files, QtWebKit HTML engine, QtConcurrent engine for multithreading etc. You might want to learn all the new goodies.
Trolltech (what's the current name?) always has good documentation, so check What's new in Qt4 and you should be fine with API reference for the latest Qt4 version.