“Pro-youthful” factors in the “labyrinth” of cardiac rejuvenation

• The myocardium is characterized by limited regenerative capacity.
• FSTL1 is an epicardial cardiogenic factor with dynamic expression after injury.
• The rejuvenating effects can be mediated by blood-borne ‘pro-youthful’ factors.
• Several growth hormone responses affect multiple signalling cascades.

The mechanisms of aging and senescence include various endogenous and exogenous factors. Among cardiovascular diseases, heart failure is a typical age-related disease. New strategies to restore cardiomyocyte cells have been reported: endogenous substances that can regenerate the heart's cardiomyocytes have been described: follistatin like 1 (FSTL1), growth-differentiation factor 11 (GDF11) and insulin-like growth factor 1 (IGF-I). Manipulation of the different anti and pro- pathways is essential to discover new approaches to regenerative therapies.