Figure 3.

Mechanisms of apelin/ELA-APJ protecting against heart failure. ELA-APJ inhibits FOXM1and ACE, then myocardial hypertrophy and HF. Apelin increases Sirt3 expression then reduces ROS formation and attenuated stress-induced apoptosis and HF. Apelin exerts a selective positive inotropic action by stimulating PKC/ERK/NHE. ELA, Elabela; APJ, angiotensin domain type 1 receptor-associated proteins;; HF, heart failure; ERK, extracellular signal-regulated kinase; ROS, reactive oxygen species; PKC, protein kinase C; ERK, extracellular signal-regulated kinase; NHE, Na(+)/H(+) exchanger.