Furthermore, both TGFβ1 and IGF1 signal through the PI3K/Akt pathway and there is an extensive crosstalk between the two signalling pathways during cardiac fibrosis (Butt et al. 1995), cardiomyocyte apoptosis (Hynes et al. 2009), cardiac remodelling following myocardial infarction (Stavropoulou et al. 2010) and cardiac hypertrophy (Lisa et al. 2011). This evidence concerns the gene IGF1 and cardiac hypertrophy.