HES1 and ischemic cardiomyopathy: Notch activity is required in complex organs like the heart that necessitate the coordinated development of multiple parts.40 Specifically, functional studies have shown that Notch activity is required for cardiovascular development and that Notch signaling causes downstream effects such as cell fate specification, cell proliferation, progenitor cell maintenance, apoptosis, and boundary formation.39 In previous studies, Hes1 expression was observed to increase following myocardial infarction and other ischemic cardiomyopathies.