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Summary So far, opposing outcomes have been reported following neonatal apex resection in mice, questioning the validity of this injury model to investigate regenerative mechanisms. We performed a systematic evaluation, up to 180 days after surgery, of the pathophysiological events activated upon apex resection. In response to cardiac injury, we observed increased cardiomyocyte proliferation in remote and apex regions, neovascularization, and local fibrosis. In adulthood, resected hearts remain consistently shorter and display permanent fibrotic tissue deposition in the center of the resection plane, indicating limited apex regrowth. However, thickening of the left ventricle wall, explained by an upsurge in cardiomyocyte proliferation during the initial response to injury, compensated cardiomyocyte loss and supported normal systolic function. Thus, apex resection triggers both regenerative and reparative mechanisms, endorsing this injury model for studies aimed at promoting cardiomyocyte proliferation and/or downplaying fibrosis., Graphical Abstract, Highlights • Apex resection triggers fibrosis, neovascularization, and cardiomyocyte proliferation • Permanent fibrotic deposition is confined to the apex • Injured hearts display morphometric alterations but regain functional competence • Cardiomyocyte proliferation is sufficient to compensate tissue loss by resection, In this article, Nascimento and colleagues demonstrate that neonatal apex resection stimulates cardiomyocyte proliferation and permanent scarring in the apex. Newly formed cardiomyocytes compensate muscle loss by resection, and resected hearts recover functional competence in adulthood. These findings endorse this model for studies aiming to block cardiac fibrosis and/or favoring CM proliferation.

Summary Notch signaling plays a role in specifying a cardiac fate but the downstream effectors remain unknown. In this study we implicate the Notch downstream effector HES5 in cardiogenesis. We show transient Hes5 expression in early mesoderm of gastrulating embryos and demonstrate, by loss and gain-of-function experiments in mouse embryonic stem cells, that HES5 favors cardiac over primitive erythroid fate. Hes5 overexpression promotes upregulation of the cardiac gene Isl1, while the hematopoietic regulator Scl is downregulated. Moreover, whereas a pulse of Hes5 instructs cardiac commitment, sustained expression after lineage specification impairs progression of differentiation to contracting cardiomyocytes. These findings establish a role for HES5 in cardiogenesis and provide insights into the early cardiac molecular network., Graphical Abstract, Highlights • Hes5 is expressed in the nascent mesoderm of gastrulating mouse embryos • Hes5 knockdown enhances primitive erythropoiesis in mESCs • A stage-specific pulse of Hes5 instructs preferential cardiac fate in mESCs • Sustained Hes5 activation impairs differentiation to contracting cardiomyocytes, Pinto-do-Ó and colleagues establish a role for HES5 in instructing cardiac versus primitive erythroid fate. Hes5 depletion enhances primitive erythropoiesis, whereas a stage-specific overexpression favors cardiac specification in mESCs. Progression of differentiation to contracting cardiomyocytes depends on Hes5 downregulation. This requirement for transient Hes5 activity for proper cardiogenesis correlates with the expression pattern observed in the mouse embryo nascent mesoderm.