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. Author manuscript; available in PMC: 2012 Jan 5.
Published in final edited form as: Cell Metab. 2011 Jan 5;13(1):3–4. doi: 10.1016/j.cmet.2010.12.012

Figure 1. Signaling Pathways Regulating Physiologic and Pathologic Cardiac Hypertrophy.

Figure 1

Neurohormonal and calcium (Ca2+) -mediated pathways can activate signaling cascades in cardiac myocytes that lead to activation of maladaptive hypertrophy. Exercise, pregnancy, and other physiologic growth stimuli can act through insulin-like growth factor (IGF) 1 to stimulate phosphoinositide-3 kinase (PI3K) and Akt, which inhibits C/EBPβ. C/EBPβ may function through inhibition of CITED4 to regulate physiologic hypertrophy and myocyte proliferation, and it may also affect the activity of serum response factor (SRF) to modulate pathologic responses (dotted lines).