A. In developing cardiomyocytes, GATA4 predominantly binds to distal enhancers of developmental genes and correlates with enrichment of H3K27 acetylation (green triangles on blue circles). Adult cardiac and non-cardiac genes, which are not expressed in developing cardiomyocytes, lack both GATA4 binding and H3K27 acetylation. B. Mature cardiomyocytes display a shift in both GATA4 occupancy and H3K27 acetylation from distal fetal enhancers to proximal adult enhancers. C. During disease states, GATA4 reactivates a subset of its developmental targets, but also binds and activates non-cardiac genes, implying that these novel targets contribute significantly to disease phenotypes.