The Frank-Starling mechanism of the heart is due, in part, to modulation of myofilament Ca 2+ sensitivity by sarcomere length (SL) [length-dependent activation (LDA)]. The molecular mechanism(s) that underlie LDA are unknown. Recent evidence has implicated the giant protein titin in this cellular process, possibly by positioning the myosin head closer to actin. To clarify the role of titin strain in LDA, we isolated myocardium from either WT or homozygous mutant (HM) rats that express a giant splice isoform of titin, and subjected the muscles to stretch from 2.0 to 2.4 μm of SL. Upon stretch, HM compared with WT muscles displayed reduced passive force, twitch force, and myofilament LDA. Time-resolved small-angle X-ray diffraction measurements of WT twitching muscles during diastole revealed stretch-induced increases in the intensity of myosin (M2 and M6) and troponin (Tn3) reflections, as well as a reduction in cross-bridge radial spacing. Independent fluorescent probe analyses in relaxed permeabilized myocytes corroborated these findings. X-ray electron density reconstruction revealed increased mass/ordering in both thick and thin filaments. The SL-dependent changes in structure observed in WT myocardium were absent in HM myocardium. Overall, our results reveal a correlation between titin strain and the Frank-Starling mechanism. The molecular basis underlying this phenomenon appears not to involve interfilament spacing or movement of myosin toward actin but, rather, sarcomere stretch-induced simultaneous structural rearrangements within both thin and thick filaments that correlate with titin strain and myofilament LDA. myofilament length-dependent activation | small-angle X-ray diffraction | rat | passive force | fluorescent probes T he Frank-Starling law of the heart describes a cardiac regulatory control mechanism that operates on a beat-to-beat basis (1). There is a unique relationship between ventricular endsystolic volume and end-systolic pressure that is determined by cardiac contractility. As a result, ventricular stroke volume is directly proportional to the extent of diastolic filling. In conjunction with heart rate and contractility, the Frank-Starling mechanism constitutes a major determinant of cardiac output. Although the Frank-Starling mechanism has been well established for well over a century, the molecular mechanisms underlying this phenomenon are not resolved (1). At the cellular level, an increase in sarcomere length (SL) results in an immediate increase in twitch force development. Existing data, mostly derived from permeabilized isolated myocardium, strongly support the notion that this phenomenon is due to an increase in the Ca 2+ responsiveness of the cardiac contractile apparatus, a phenomenon termed "myofilament lengthdependent activation" (LDA) (1).The mechanism by which the mechanical strain signal is transduced by the cardiac sarcomere is not known. We have recently demonstrated that LDA develops within a few milliseconds following a change in SL (2), a finding suggestive of a mole...