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Systemic corticosteroid concentration depends largely on the activity of the hypothalamic\u2013pituitary\u2013adrenal (HPA) axis, but glucocorticoid can also be regenerated from intrinsically inert metabolites by the enzyme 11\u03b2-hydroxysteroid dehydrogenase type 1 (11\u03b2-HSD1), selectively increasing glucocorticoid levels within cells and tissues. Extensive studies have revealed the roles for glucocorticoid regeneration by 11\u03b2-HSD1 in liver, adipose, brain and other tissues, but until recently, there has been little focus on the heart. This article reviews the evidence for glucocorticoid metabolism by 11\u03b2-HSD1 in the heart and for a role of 11\u03b2-HSD1 activity in determining the myocardial growth and physiological function. We also consider the potential of 11\u03b2-HSD1 as a therapeutic target to enhance repair after myocardial infarction and to prevent the development of cardiac remodelling and heart failure.<\/jats:p>","DOI":"10.1530\/jme-16-0128","type":"journal-article","created":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T22:18:26Z","timestamp":1471990706000},"page":"R1-R13","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-6","source":"Crossref","is-referenced-by-count":37,"title":["Getting to the heart of intracellular glucocorticoid regeneration: 11\u03b2-HSD1 in the myocardium"],"prefix":"10.1530","volume":"58","author":[{"given":"Gillian A","family":"Gray","sequence":"first","affiliation":[{"name":"University\/BHF Centre for Cardiovascular ScienceQueen\u2019s Medical Research Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher 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