issue of Circulation, this article provides compelling evidence that the G αq -protein-coupled receptor (GPCR)/InsP3R axis plays a critical role in the regulation of cardiomyocyte calcium homeostasis, electric stability, and contractile performance. The authors demonstrate that GPCR agonists generate InsP3, which activates InsP3Rs to liberate calcium from internal stores, resulting in decreased resting membrane potential, prolongation of myocyte action potential, and the occurrence of early afterdepolarizations. These mechanisms cause electric instability and contractile abnormalities.However, when studying the regulation of calcium homeostasis by InsP3Rs in a given system (eg, in cardiomyocytes), listening to the entire orchestra is key to unequivocally hearing all tones and undertones of the concert. InsP3R function is regulated by at least 3 distinct mechanisms: at the point of InsP3 generation, which basically acts as the on/off switch of the channel (eg, by GPCR agonists); at the level of InsP3R protein expression; and by endogenous InsP3R regulators.2 The last regulatory mechanism of InsP3R function we missed being addressed by the authors of this otherwise thoroughly conducted study.We have recently shown that a well-known and extensively studied important endogenous regulator of the InsP3R, chromogranin B (CGB), is expressed in cardiomyocytes.3 CGB, an acidic calcium storage protein, acts as a positive modulator of InsP3R activity. 4 In cardiomyocytes, we showed that CGB functionally interacts with the InsP3R to shape GPCR agonist-driven, InsP3-dependent calcium release from internal stores, being responsible for the differential activation of calcium-dependent transcription factors in cardiomyocyte excitation-transcription coupling.3 Therefore, considering that activation of the GPCR/InsP3R axis in cardiomyocytes potentially has both electromechanical and transcriptional implications, we believe it is important to carefully examine all regulatory mechanisms of InsP3R channel activity possibly being involved within a given system. Otherwise, subtle tones and undertones within the complex cardiomyocyte calcium signaling concert can easily be missed.Signaling specificity of the multifunctional second messenger calcium is achieved by variations in and combinations of the magnitude, frequency, and duration of calcium signals, parameters that are potentially being modified by fine-tuning of InsP3R activity by its endogenous regulators such as CGB. Subtle variations in InsP3-dependent calcium wave patterns may make the difference in beneficial (eg, selective activation of calcium-dependent transcription factors) versus adverse (eg, electric instability) effects of InsP3R activation in cardiomyocytes and the diseased myocardium.When the data of this article are integrated with the data in another recently published study, the CGB/InsP3R interaction may become even more pronounced in the failing human heart, with markedly increased ventricular InsP3R type 2 protein expression paralleling increased CGB expression...