Abstract-Despite its importance for the regulation of heart function, little is known about the isoform expression of the multifunctional Ca 2ϩ /calmodulin-dependent protein kinase (CaMKII) in human myocardium. In this study, we investigated the spectrum of CaMKII isoforms ␦ 2 , ␦ 3 , ␦ 4 , ␦ 8 , and ␦ 9 in human striated muscle tissue. Isoform ␦ 3 is characteristically expressed in cardiac muscle. In skeletal muscle, specific expression of a new isoform termed ␦ 11 is demonstrated. Complete sequencing of human ␦ 2 cDNA, representing all common features of the investigated CaMKII subclass, revealed its high homology to the corresponding rat cDNA. Comparative semiquantitative reverse transcription-polymerase chain reaction analyses from left ventricular tissues of normal hearts and from patients suffering from dilated cardiomyopathy showed a significant increase in transcript levels of isoform ␦ 3 relative to the expression of glyceraldehyde-3-phosphate dehydrogenase in diseased hearts (101.6Ϯ11.0% versus 64.9Ϯ9.9% in the nonfailing group; PϽ0.05, nϭ6). Transcript levels of the other investigated cardiac CaMKII isoforms remained unchanged. At the protein level, by using a subclass-specific antibody, we observed a similar increase of a ␦-CaMKII-specific signal (7.2Ϯ1.0 versus 3.8Ϯ0.7 optical density units in the nonfailing group; PϽ0.05, nϭ4 through 6). The diseased state of the failing hearts was confirmed by a significant increase in transcript levels for atrial natriuretic peptide (292.9Ϯ76.4% versus 40.1Ϯ3.2% in the nonfailing group; PϽ0.05, nϭ3 through 6). Our data characterize for the first time the ␦-CaMKII isoform expression pattern in human hearts and demonstrate changes in this expression pattern in heart failure. (Circ Res. 1999;84:713-721.)