“…In the heart, the IGF-IIR disruption leads to cellular protection against cardiomyocyte apoptosis (Chen et al, 2004) and IGF-II and IGF-IIR up regulation in cardiomyocytes have been identified in a variety of heart disease models (Lee et al, 2006;Chang et al, 2008;Chu et al, 2008Chu et al, , 2009b. IGF-IIR could also function as a G proteincoupled receptor to trigger its downstream signaling modulators such as PKC-a/CaMKII, calcineurin and MMP/ TIMP, contributing to heart failure progression (Chang et al, 2008;Chu et al, 2008Chu et al, , 2009aChen et al, 2009). The upregulation of IGF-IIR gene expression occurred in this study after treatment with ANGII, LPS, inomycin, and TNF-a (Fig.…”