Determining how cells distinguish between adaptive and maladaptive signals when they appear to share the same molecular pathways has been a vexing biological problem. The ability to identify distinctive features of a pathophysiological response compared with a physiological response would allow for the rational design of approaches to eliminate or diminish undesirable consequences of pathophysiological responses while preserving the beneficial effects of physiological signals. These issues are especially pertinent in the heart and in understanding the development of heart failure, for which >500,000 new cases are diagnosed in the United States each year. Major factors contributing to worsening heart failure include a number of compensatory neurohormonal signals intended to counteract decreased cardiac output, such as hyperadrenergic stimulation (1). In a recent issue of PNAS, Balijepalli et al. (2) provide new insight into how adrenergic signaling pathways are organized in the heart.
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