Background: During heart failure, gene and protein expression profiles undergo extensive compensatory and pathological remodeling. We have previously observed that fast skeletal myosin binding protein-C (fMyBP-C) is upregulated in diseased mouse hearts. While fMyBP-C shares significant homology with its cardiac paralog, cardiac myosin binding protein-C (cMyBP-C), there are key differences in the functional differences which may affect cardiac function. Also, it is unknown if the fMyBP-C expression in the heart is a pathological or compensatory response. Objectives: We aim to elucidate the consequence of increased fMyBP-C expression in the heart. Methods: To determine the sufficiency of fMyBP-C to cause cardiac dysfunction, we generated cardiac-specific fMyBP-C over-expression mice. These mice were further crossed into a cMyBP-C null model to assess the effect of fMyBP-C in the heart in the absence of cMyBP-C function. Finally, fMyBP-C knockout mice were subjected to transverse aortic constriction (TAC) to define the requirement of fMyBP-C during heart failure development. Results: We confirmed the upregulation of fMyBP-C in several models of cardiac disease. Genetic over-expression of low levels of fMyBP-C caused mild cardiac remodeling and sarcomere dysfunction. High expression of fMyBP-C in a heart failure model further exacerbated the cardiac disease, hypertrophy and fibrosis. On the other hand, following 8 weeks of TAC, fMyBP-C null mice demonstrated greater protection against heart failure development. Mechanistically, this may be due to the greater instability of the myosin super-relaxed state compared to wild-type littermates. Conclusions: These findings suggest that the elevated expression of fMyBP-C in diseased hearts is a pathological response. Targeted therapies to prevent upregulation of fMyBP-C may prove beneficial in the treatment of heart failure.
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