Cardiac myosin-binding protein C (cMyBP-C) is an accessory protein of striated muscle sarcomeres that is vital for maintaining regular heart function. Its 4 N-terminal regulatory domains, C0-C1-m-C2 (C0C2), influence actin and myosin interactions, the basic contractile proteins of muscle. Using neutron contrast variation data, we have determined that C0C2 forms a repeating assembly with filamentous actin, where the C0 and C1 domains of C0C2 attach near the DNase I-binding loop and subdomain 1 of adjacent actin monomers. Direct interactions between the N terminus of cMyBP-C and actin thereby provide a mechanism to modulate the contractile cycle by affecting the regulatory state of the thin filament and its ability to interact with myosin.familial hypertrophic cardiomypathy ͉ C protein ͉ muscle regulation ͉ neutron contrast variation ͉ small-angle scattering I nterest in cardiac myosin-binding protein C (cMyBP-C) has been stimulated in recent times because of its influence on fine-tuning heart muscle contraction and its links to inherited cardiac disorders (1). Medical research estimates that up to 1 in 500 adolescents and young adults is affected by the diverse genetic condition known as familial hypertrophic cardiomyopathy (FHC) (2), which presents as a gradual thickening of the ventricle walls of the heart and a correlated increase in the risk of heart failure. Approximately 63% of FHC cases are attributable to mutations in genes that encode sarcomeric proteins, the majority of which (42%) are mutations in the MYBPC3 gene (3). Of the 150 known FHC-causing mutations distributed throughout the MYBPC3 gene, 26 are located in the region that encodes the 4 N-terminal domains of the protein.The primary components of muscle thick and thin filaments are the proteins myosin and actin, respectively. Muscle shortens and develops force as thin filaments slide past thick filaments via the cyclic interactions of myosin cross-bridges (myosin-S1) extending from the thick filament to actin. These actomyosin interactions are regulated in part by calcium signals that are transmitted via thin-filament accessory proteins troponin and tropomyosin, whose movement on the thin filament unveils myosin-binding sites, permitting productive (weak to strong binding) cross-bridge transitions (4). Originally identified as a thick filament accessory protein, myosin-binding protein C (MyBP-C) also provides a thick-filament accessory protein, provides an additional regulatory layer to the contractile cycle, but the precise molecular mechanisms by which it influences actomyosin interactions are not understood. Belonging to the Ig/fibronectin superfamily of proteins, cMyBP-C consists of 11 sequentially ordered domains (C1, m, C2-C10, common to all isoforms), plus a cardiac specific N-terminal domain (C0) and proline/alanine-rich region that links C0 to C1. The N-terminal domains (C0-C1-m-C2 or C0C2) perform the regulatory functions by influencing myosin head interactions with actin filaments (5-7), whereas the C-terminal domains of cMyBP-C (C7-C10...