Reactivation of fetal gene expression during hypertrophy and heart failure. A: α-myosin heavy chain (MHC) and β-MHC gene expression decrease and increase respectively with heart failure in PAC RV compared with sham (*P < 0.05). There is also an increase in the expression of other fetal genes including atrial natriuretic peptide (ANP, B) and α-actin (C). D: SERCA expression was downregulated with hypertrophy and heart failure (ANOVA P < 0.05). E: expression of miR-208a and 208b parallel the changes in α-MHC and β-MHC gene expression. During early hypertrophy miR-208a predominates in the RV. As hypertrophy progresses, there is a shift from miR-208a to 208b. With the development of heart failure, there is a dramatic increase in miR-208b, while miR-208a remains downregulated (*P < 0.05). **P < 0.01, ***P < 0.001.