Notably, however, an overly simplistic total inhibition of H2O2 may not be desirable with all signaling steps, as certain prolonged high levels of H2O2 may promote cardiac hypertrophy rather than atrophy [63] and the anabolic IGF-1-Akt pathway may be activated by H2O2, at least in myotubes [64]. Here, IGF1 is linked to cardiac hypertrophy.