Specific MEF2C and PGC-1α splicing variants are in fact able to activate the expression of IGF1 [74,220], hence it is conceivable that alterations of their splicing patterns could contribute to this aspect of the pathology, an hypothesis that is also reinforced by the observation that cardiac hypertrophy following heart failure has been related to alterations of the splicing pattern of MEF2C transcripts in the heart [165]. This evidence concerns the gene PPARGC1A and cardiac hypertrophy.