“…According to its conventional role, IGF-IIR functions as a death receptor or a tumor suppression gene involved in the cytotoxic T cell-induced apoptosis and tumorigenesis (Motyka et al, 2000;Leboulleux et al, 2001). 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).…”