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Figure 4 Grading of the contractile proteins in myocytes before and after left ventricular assist device (LVAD) support. Myosin staining showed some deterioration (grade 4.6 before LVAD implantation vs. 3.6 after LVAD support; p = 0.058). In contrast, the contractile proteins of the thin filaments and titin showed improvement (grade 1.4 for actin before LVAD implantation vs. 2.7 after LVAD support; p = 0.004). Severe structural myocyte damage persisted, despite a period of LVAD support of 213 ± 135 days. HTx = heart transplantation; Trop = troponin.