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Locations and proposed mechanism of titin acetylation. (A) Titin acetylation sites detected in rat heart tissue by mass spectrometry (data obtained from Ref.70). (B) Locally increased acetylation of elastic titin in HFpEF may be due to reduced deacetylase activity of SIRT1; this increases titin-based stiffness. Treatment with NAD+/NAM restores SIRT1 activity to reverse this process. Brown arches depict titin spring stiffness. aa, amino acid.
