Review Article

Repair Injured Heart by Regulating Cardiac Regenerative Signals

Table 1

Extracellular signals for cardiac regeneration.

Extracellular signalsReceptorSignal pathwayBiological effectsClinical effects on HF patients
In vitroIn vivo

Triiodothyronine (T3) TR1α (thyroid hormone receptor α1) ① AMPK↑ [10]
② Regulating IGF1/IGF1-R/AKT [13]
③ ERK↑ [11]
CM growth↑ [10],
CM maturation↑ [4],
myofilament proteins expression↑ [12],
L-type Ca2+ channel↓ [6]
CM proliferation and cardiac regeneration↑ [2],
cardiac ischemia-reperfusion injury↓ [1517],
cardiac remodeling↓ [16, 18, 19]
Ventricular performance↑ [23],
cardiac index↑ [24],
cardiac function not improved [25],

Neuregulin-1 (NRG1)ErbB receptor① ERK1/2MAPK↑ [34]
② PI3KAKT↑ [35, 36]
③ FAK↑ [37]
CM survival↑ [36],
calcium handling↑ [39],
CM communication↑ [40, 41],
myofibrillar structural damage in response to ErbB inhibition [38]
Development of cardiac conduction system↑ [45, 46],
CM dedifferentiation and proliferation↑ [42, 43],
myofilament organization↑ [44]
cardiac output↑,
LVEF↑,
systemic vascular resistance↓,
ESV↓ EDV↓ [50, 51]

Follistatin-like 1 (Fstl1)DIP2A (disconnected interacting protein 2 homolog A) ① AMPK↑ [57]
② p-AKT↑ [58]
③ ERK1/2↑ [55]
Cell apoptosis↓ [58]Cardiac rupture↓ [55],
CM proliferation↑, heart performance↑ [56]
N/A

TNF-related weak inducer of apoptosis (TWEAK)Fn14 receptor① TRAFNF-κB↑ [68]
② ERK [70]
③ PI3KAKT↑ [70]
CM cell cycle reentry↑ [70],
cardiomyocyte proliferation↑ [69],
CM-derived proinflammatory cytokines↑ [68],
fibroblast proliferation and myofibroblast differentiation↑ [71]
Cardiac hypertrophy↑ [72],
myocardial inflammatory responses↑ [73],
heart performance↓ [74]
N/A

CM: cardiomyocyte; ↑: increase or intensify; ↓: decrease; LVEF: left ventricular ejection fraction; ESV: end-systolic volume; EDV: end-diastolic volume; N/A: not available.