This mirrors transcriptional changes in human CMs from the border zone of myocardial infarcts.37 In these studies, using pseudotime analysis, ‘prestressed’ CMs expressed ANKRD1 and the subsequent emergence of AP-1 transcription factors such as ATF3 and up-regulation of their target genes herald the transition from prestressed to stressed state accompanied by expression of NPPB. The gene discussed is ATF3; the disease is myocardial infarction.