In that respect, in a pathological rat model of HF induced by pressure overload, which goes along with strong cardiac hypertrophy, cardiac function alteration, tissue remodeling, bioenergetic alterations and cardiomyocyte cell death,45, 46 sACt is downregulated and Epac1 is upregulated in mitochondria. The gene discussed is RAPGEF3; the disease is hydrops fetalis.