The cardiac troponin I (cTnI) R145W mutation is associated with restrictive cardiomyopathy (RCM). Recent evidence suggests that this mutation induces perturbed myofilament lengthdependent activation (LDA) under conditions of maximal protein kinase A (PKA) stimulation. Some cardiac disease-causing mutations, however, have been associated with a blunted response to PKA-mediated phosphorylation; whether this includes LDA is unknown. Endogenous troponin was exchanged in isolated skinned human myocardium for recombinant troponin containing either cTnI R145W, PKA/PKC phosphomimetic charge mutations (S23D/S24D and T143E), or various combinations thereof. Myofilament Ca 2؉ sensitivity of force, tension cost, LDA, and single myofibril activation/relaxation parameters were measured. Our results show that both R145W and T143E uncouple the impact of S23D/S24D phosphomimetic on myofilament function, including LDA. Molecular dynamics simulations revealed a marked reduction in interactions between helix C of cTnC (residues 56, 59, and 63), and cTnI (residue 145) in the presence of either cTnI RCM mutation or cTnI PKC phosphomimetic. These results suggest that the RCM-associated cTnI R145W mutation induces a permanent structural state that is similar to, but more extensive than, that induced by PKC-mediated phosphorylation of cTnI Thr-143. We suggest that this structural conformational change induces an increase in myofilament Ca 2؉ sensitivity and, moreover, uncoupling from the impact of phosphorylation of cTnI mediated by PKA at the Ser-23/Ser-24 target sites. The R145W RCM mutation by itself, however, does not impact LDA. These perturbed biophysical and biochemical myofilament properties are likely to significantly contribute to the diastolic cardiac pump dysfunction that is seen in patients suffering from a restrictive cardiomyopathy that is associated with the cTnI R145W mutation.Cardiomyopathies are diseases of the heart muscle that are either acquired or inherited (1). Several forms of the disease are formally recognized, including dilated cardiomyopathy, hypertrophic cardiomyopathy (HCM), 2 and restrictive cardiomyopathy (RCM) cardiomyopathy. Numerous mutations in sarcomeric proteins have been identified that associate with, and may indeed be causal to, inherited cardiomyopathy, notably the giant elastic protein titin (TTN) in dilated cardiomyopathy (2) and myosin heavy chain (MYH7) and myosin-binding protein C (MYBPC3) in HCM (3). RCM is a rare form of cardiomyopathy characterized by severe diastolic dysfunction secondary to significant increased ventricular diastolic stiffness but without the prominent increase in wall thickness that is commonly seen in HCM (4). RCM is associated with a poor prognosis (1), and the inherited form is believed to be caused by mutations in various sarcomeric proteins, including cardiac troponin I (TNNI3) (5).Troponin-I (TnI) is the inhibitory component of troponin, the trimeric thin filament-associated protein complex that mediates calcium-initiated contraction in striated muscle (see Fig...