Review ArticlesHypoxia-Inducible Factor-1 Alpha in the Heart A Double Agent?Hashmi, Satwat MD; Al-Salam, Suhail MD Author Information From the Department of Pathology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates. Disclosure: The authors declare no conflicts of interest and sources of funding. Correspondence: Suhail Al-Salam, MD, Department of Pathology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain PO Box 17666, Al-Ain, United Arab Emirates. E-mail: [email protected]. Cardiology in Review: November/December 2012 - Volume 20 - Issue 6 - p 268-273 doi: 10.1097/CRD.0b013e31826287f6 Buy Metrics Abstract Hypoxia-inducible factor (HIF) is a set of transcription factors that regulate the cellular response to hypoxia. There is a great body of evidence supporting the protective role of HIF-1α in cardiovascular pathophysiology, however, newer studies are hinting at a maladaptive and deleterious role of this transcription factor that merits further investigation. There is a general agreement, however, that HIF-mediated responses appear to differ under conditions of acute and chronic oxygen deprivation. The intensity and sustainability of HIF-1α activation are major determinants of whether the responses are pathological or beneficial. HIF activation is seen to be beneficial in the setting of acute myocardial ischemia and deleterious in chronic conditions. In this review, we will focus on recent insights into the role of HIF-1α in the heart and especially in the setting of ischemic heart disease. © 2012 Lippincott Williams & Wilkins, Inc.