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We thank Sardu and colleagues for their comments. Our report demonstrates that baseline levels of microRNA-30d (miR-30d) are correlated with response to cardiac resynchronization therapy and that miR-30d was dynamically regulated by mechanical stress.1 Moreover, miR-30d appeared to be an adaptive response and was cardioprotective against tumor necrosis factor-α–mediated apoptosis. Similar to our study, Marfella et al2 noted differential expression of several plasma miRNAs in cardiac resynchronization therapy responders versus nonresponders 1 year after cardiac resynchronization therapy. The lack of significant overlap between the sets of extracellular miRNAs reflects some of the ongoing issues in extracellular RNA research. The first issue is differences in patient populations and small sample sizes. The second is variances in methodology. Several groups, including …

circulation

Response to Letter Regarding Article, “Circulating MicroRNA-30d Is Associated With Response to Cardiac Resynchronization Therapy in Heart Failure and Regulates Cardiomyocyte Apoptosis: A Translational Pilot Study”