Sarcomeric protein isoform transitions in cardiac muscle: A journey to heart failure

• Sarcomeric protein isoforms undergo developmental changes.
• Abnormal isoform transitions are associated with alterations in sarcomeric function.
• Sarcomeric function plays a cardinal role in the development of heart failure.
• Manipulation of isoform transitions is a therapeutic strategy for heart failure.

Sarcomeric protein isoforms are mainly governed by alternative promoter-driven expression, distinct gene expression, gene mutation and alternative mRNA splicing. The transitions of sarcomeric proteins have been implicated to play a role in the onset and development of human heart failure. In this mini-review, we summarized isoform transitions of several most widely examined sarcomeric proteins including myosin, actin, troponin, tropomyosin, titin and myosin binding protein-C, and the consequence of these abnormal isoform transitions. Even though the isoform transitions of sarcomeric proteins have been described in individual sarcomeric protein reviews, no concise summary of these results has been presented previously. This review is intended to fill this gap and discuss possible future perspectives.