secreted from the myocardium into serum, having a limited effect on muscle growth. However, increases in cardiac myostatin can increase its serum concentration, which may cause skeletal muscle atrophy. Pathological states that increase cardiac stress and promote heart failure can induce a rise in both cardiac myostatin mRNA and protein levels within the heart. In ischemic or dilated cardiomyopathy, increased levels of myostatin mRNA have been detected within the left ventricle. As a member of the TGF-β family, myostatin may play a role in post-infarct recovery. It has been hypothesized that hypertrophy of the heart induces an increase in myostatin as a negative feedback mechanism in an attempt to limit further myocyte growth. This process includes mitogen-activated protein kinases and binding of the MEF2 transcription factor within the promoter region of the myostatin gene. Increases in myostatin levels during chronic heart failure have been shown to cause cardiac cachexia. Systemic inhibition of cardiac myostatin with the JA-16 antibody maintains overall muscle weight in experimental models with pre-existing heart failure. Myostatin also alters excitation-contraction (EC) coupling within the heart. A reduction in cardiac myostatin induces eccentric hypertrophy of the heart, and increases its sensitivity to beta-adrenergic stimuli by enhancing Ca2+ release from the SR during EC coupling. Also, phospholamban phosphorylation is increased in myostatin-knockout mice, leading to an increase in Ca2+ release into the cytosol during systole. Therefore, minimizing cardiac myostatin may improve cardiac output. See also Muscular dystrophy Muscle hypertrophy Myostatin-related muscle hypertrophy Superhuman strength References External links GeneReviews profile NPR.org: Myostatin Therapies Hold Hope for Muscle Diseases by Jon Hamilton Times Colonist Big Wendy the muscular whippet Growth factors Muscular dystrophy TGFβ domain Human proteins Genes mutated in mice Genes on human chromosome 2