1. Heart failure rates have reached epidemic proportions in Western society. 2. New strategies proposed to improve cardiac function of the failing heart include regeneration, stem cell therapy, innovative methods for the revascularization of ischaemic cardiac tissue and the activation of signalling pathways that promote physiological growth (hypertrophy). 3. The insulin-like growth factor 1-phosphoinositide-3-kinase pathway is a well characterized regulator of physiological hypertrophy. 4. In this mini-review we present studies that suggest promoting physiological hypertrophy in the failing heart may be beneficial.