PPARGC1A and cardiac hypertrophy: Under physiological conditions of increased energy demand, including exercise and fetal heart development, the elevated level of PGC-1α promotes mitochondrial biogenesis and ameliorates energy metabolism.370,371 In contrast to this, during pathological myocardial hypertrophy, the expression of PGC-1α is downregulated, which is also associated with a net loss of mitochondrial protein and oxidative capacity.372,373