sponding to the synchronized contraction of the myocardium and rhythmic pumping function of the heart, a single form of cardiac troponin T (cTnT) is present in the adult cardiac muscle of humans and most other vertebrate species. Alternative splicing variants of cTnT are found in failing human hearts and animal dilated cardiomyopathies. Biochemical analyses have shown that these cTnT variants are functional and produce shifted myofilament Ca 2ϩ sensitivity. We proposed a hypothesis that the coexistence of two or more functionally distinct TnT variants in the adult ventricular muscle that is normally activated as a syncytium may decrease heart function and cause cardiomyopathy (Huang et al., Am J Physiol Cell Physiol 294: C213-C222, 2008). In the present study, we studied transgenic mouse hearts expressing one or two cTnT variants in addition to normal adult cTnT to investigate whether desynchronized myofilament activation decreases ventricular efficiency. The function of ex vivo working hearts was examined in the absence of systemic neurohumoral influence. The results showed that the transgenic mouse hearts produced lower maximum left ventricular pressure, slower contractile and relaxation velocities, and decreased stroke volume compared with wild-type controls. Ventricular pumping efficiency, calculated by the ejection integral versus total systolic integral and cardiac work versus oxygen consumption, was significantly lower in transgenic mouse hearts and corresponded to the number of cTnT variants present. The results indicated a pathogenic mechanism in which the coexistence of functionally different cTnT variants in cardiac muscle reduces myocardial efficiency due to desynchronized thin filament activation. cardiac function; muscle contraction; cardiomyopathy; heart failure DIFFERENT FROM SKELETAL MUSCLE, which functions with tetanic contraction fused from a series of twitches, cardiac muscle is activated as an electrical syncytium to produce synchronized contractions for rhythmic pumping. An effective generation of peak ventricular pressure over aortic pressure is essential for cardiac output and efficiency.During the contraction of vertebrate cardiac myocytes, allosteric changes in troponin C (TnC) induced by Ca 2ϩ binding are transmitted to other subunits of troponin and the actin filament (16). Troponin T (TnT) is the thin filament-anchoring subunit of the troponin complex (28). As an essential element in the Ca 2ϩ signaling system in cardiac and skeletal muscles, TnT interacts with TnC, troponin I (TnI), and tropomyosin to regulate the actin thin filament during contraction and relaxation (16, 28). Three muscle type-specific TnT isoform genes [cardiac (cTnT), fast skeletal, and slow skeletal] have evolved in vertebrates, and each encodes multiple alternative splice forms (25). The structure of the NH 2 -terminal region of TnT is hypervariable, and variations in this region modulate the conformation and function of TnT and the contractility of muscle (3-5, 9, 22, 23, 30).Skeletal muscle expresses both sl...