Changing components of the mechanosensing apparatus. A) Schematic of the integrin adhesions in the costameres and their connection to the sarcomere. Note only a few relevant components are displayed and proteins are not in scale. B) Overview of the different isoforms for ECM proteins, integrins and talin, as well as different downstream effects in embryonic, healthy adult and diseased hearts. Red arrows indicate events that can lead to progression to heart failure, i.e. the downregulation of β1D integrin through talin 1 overexpression, leading to apoptosis and heart failure; and heightened RhoA activity, which is also associated with heart failure. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)