The schematic diagram summarized the molecular mechanisms by which IMD induced protective autophagy to suppress apoptosis in hypertrophic cardiomyocytes.

<p>In response to hypertrophic stimuli exposure, the hypertrophy is paralleling with the apoptosis in cardiomyocytes. IMD attenuates the hypertrophic stimuli-induced cardiomyocyte size increase and apoptosis by augmenting the protective autophagy level through the activation of cAMP/PKA and MAPK/ERK1/2 pathways. IMD, intermedin; CRLR, calcitonin receptor-like receptor; RAMP, receptor activity-modifying proteins.