Figure 1.

Neurohormonal signaling cascades converge on gene transcription to promote HF. Diagram of cardiac stress signaling pathways and their downstream effectors that converge on the transcriptional machinery to promote the development of cardiac hypertrophy and fibrosis, leading to HF. Signaling cascades activate well-known transcription factors, including the nuclear factor of activated T-cells (NFAT), myocyte enhancer factor 2 (MEF2), and GATA-binding protein 4 (GATA4), which are involved in pathological gene expression changes. AC, adenylyl cyclase; AT1R, angiotensin II receptor type 1; β-AR, beta-adrenergic receptor; phospholipase C; PKA, protein kinase A.