{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:14:07Z","timestamp":1783419247162,"version":"3.54.6"},"reference-count":57,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Coarctation of the aorta (CoA) is a congenital narrowing of the aortic isthmus near the ductus arteriosus or ligamentum arteriosum. Despite successful anatomical repair, patients remain at risk of recoarctation, arterial hypertension, and diffuse aortopathy, suggesting intrinsic vessel-wall abnormalities beyond localized obstruction. The developmental and molecular basis of these persistent vascular features remains incompletely understood. Methods: Human aortic tissue samples were obtained from 8 male infants with CoA and 6 age- and sex-matched controls aged &lt;1 year. Total RNA was isolated, and gene expression profiling was performed using whole human genome oligo microarrays (Agilent). Differentially expressed transcripts were subjected to pathway, network, and upstream regulator analyses using Ingenuity Pathway Analysis (IPA, Qiagen). Selected candidate genes were evaluated by RT-qPCR in independent verification sets. Results: Transcriptomic profiling identified 402 analysis-ready transcripts distinguishing CoA from control tissue. Exploratory pathway analyses suggested extracellular matrix remodeling characterized by collagen turnover, integrin-mediated cell\u2013matrix interactions, wound-healing signaling, and fibrosis-associated programs. In addition, enrichment analyses identified developmental annotations involving retinoic acid (RA)\/RAR\/RXR signaling, HOX-associated developmental programs, and a shared HOX\/MEIS-associated signature. Network and upstream regulator analyses further suggested associations with cytoskeletal, muscle-associated, and epigenetic regulatory pathways, including KAT6A, KAT6B, retinoic acid\/RAR\/RXR signaling, DNMT3B, KMT2A, and ARID1A. RT-qPCR independently confirmed increased expression of EDN1, AGTR2, IRS4, and TFAP2B.Conclusions: Infantile CoA tissue exhibited molecular signatures consistent with vessel-wall remodeling accompanied by developmental, vascular signaling, and smooth muscle\/cytoskeletal regulatory programs. These findings support the hypothesis that developmental patterning signals and postnatal extracellular matrix remodeling coexist within CoA tissue and may contribute to persistent vascular abnormalities beyond anatomical repair. Given the exploratory nature of the study, these observations should be considered hypothesis-generating and require validation in independent cohorts.<\/jats:p>","DOI":"10.3390\/jcm15135214","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:39:11Z","timestamp":1783078751000},"page":"5214","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Developmental and Structural Alterations at the Ductus\u2013Aortic Isthmus Interface in Infantile Coarctation of the Aorta: A Biological Basis for Persistent Vascular Disease Beyond Anatomical Repair"],"prefix":"10.3390","volume":"15","author":[{"given":"Isabell G.","family":"Robl","sequence":"first","affiliation":[{"name":"Neonatology and Pediatric Intensive Care, Faculty of Medicine, University of Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Cesnjevar","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), Krankenhausstra\u00dfe 12, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6099-7066","authenticated-orcid":false,"given":"Arif B.","family":"Ekici","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), Schwabachanlage 10, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Uebe","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), Schwabachanlage 10, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal D.","family":"Johann","sequence":"additional","affiliation":[{"name":"Pediatric and Adolescent Medicine, Swabian Children\u2019s Cancer Center Augsburg, EU-RHAB Trial Center, Germany and Bavarian Cancer Research Center (BZKF), 86156 Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Daniela Hernandez","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Pediatric and Adolescent Medicine, Swabian Children\u2019s Cancer Center Augsburg, EU-RHAB Trial Center, Germany and Bavarian Cancer Research Center (BZKF), 86156 Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7488-6885","authenticated-orcid":false,"given":"Victoria E.","family":"Fincke","sequence":"additional","affiliation":[{"name":"Pediatric and Adolescent Medicine, Swabian Children\u2019s Cancer Center Augsburg, EU-RHAB Trial Center, Germany and Bavarian Cancer Research Center (BZKF), 86156 Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5480-0204","authenticated-orcid":false,"given":"Fabian B.","family":"Fahlbusch","sequence":"additional","affiliation":[{"name":"Neonatology and Pediatric Intensive Care, Faculty of Medicine, University of Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Moosmann","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1055\/s-0030-1254155","article-title":"Prevalence of congenital heart defects in newborns in Germany: Results of the first registration year of the PAN Study (July 2006 to June 2007)","volume":"222","author":"Lindinger","year":"2010","journal-title":"Klin. Padiatr."},{"key":"ref_2","first-page":"221","article-title":"Incidence of congenital heart defects in the Czech Republic\u2014Current data","volume":"75","author":"Sipek","year":"2010","journal-title":"Ceska Gynekol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"487","DOI":"10.5603\/CJ.2011.0003","article-title":"Coarctation of the aorta: From fetal life to adulthood","volume":"18","author":"Kenny","year":"2011","journal-title":"Cardiol. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/S1010-7940(01)00996-4","article-title":"Surgery for aortic coarctation: A 30 years experience","volume":"20","author":"Corno","year":"2001","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1161\/01.CIR.41.6.1067","article-title":"Anomalies associated with coarctation of aorta: Particular reference to infancy","volume":"41","author":"Becker","year":"1970","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/0002-9149(88)91327-6","article-title":"Coarctation of the aorta, bicuspid aortic valve and abnormal ascending aortic wall","volume":"61","author":"Lindsay","year":"1988","journal-title":"Am. J. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Moosmann, J., Uebe, S., Dittrich, S., Ruffer, A., Ekici, A.B., and Toka, O. (2015). Novel loci for non-syndromic coarctation of the aorta in sporadic and familial cases. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0126873"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.2174\/156652412798889027","article-title":"Functional null mutations in the gonosomal homologue gene TBL1Y are associated with non-syndromic coarctation of the aorta","volume":"12","author":"Tagariello","year":"2012","journal-title":"Curr. Mol. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1016\/j.ijcard.2012.09.084","article-title":"Hypertension after repair of aortic coarctation\u2014A systematic review","volume":"167","author":"Canniffe","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/00045415-200205000-00002","article-title":"Interventions for aortic coarctation","volume":"10","author":"Hornung","year":"2002","journal-title":"Cardiol. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.amjcard.2015.05.052","article-title":"Risk of Systemic Hypertension and Cerebrovascular Accident in Patients with Aortic Coarctation Aged <60 Years (from a National Database Study)","volume":"116","author":"Wu","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1136\/heartjnl-2014-307035","article-title":"Late outcomes in adults with coarctation of the aorta","volume":"101","author":"Choudhary","year":"2015","journal-title":"Heart"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.athoracsur.2015.03.099","article-title":"High Prevalence of Hypertension and End-Organ Damage Late After Coarctation Repair in Normal Arches","volume":"100","author":"Lee","year":"2015","journal-title":"Ann. Thorac. Surg."},{"key":"ref_14","first-page":"100094","article-title":"Transcriptome analysis of the aortic coarctation area","volume":"10","author":"Ellegard","year":"2024","journal-title":"J. Mol. Cell. Cardiol. Plus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1136\/hrt.41.3.268","article-title":"Coarctation, tubular hypoplasia, and the ductus arteriosus. Histological study of 35 specimens","volume":"41","author":"Ho","year":"1979","journal-title":"Br. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/0002-9149(72)90042-2","article-title":"Hemodynamic considerations in the development of narrowing of the aorta","volume":"30","author":"Rudolph","year":"1972","journal-title":"Am. J. Cardiol."},{"key":"ref_17","first-page":"e3690","article-title":"Coarctation of Aorta in Children","volume":"10","author":"Doshi","year":"2018","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1161\/01.ATV.19.7.1589","article-title":"Smooth muscle cell origin and its relation to heterogeneity in development and disease","volume":"19","author":"DeRuiter","year":"1999","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1126\/science.6844926","article-title":"Neural crest cells contribute to normal aorticopulmonary septation","volume":"220","author":"Kirby","year":"1983","journal-title":"Science"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1002\/bdrc.10002","article-title":"Neural crest and cardiovascular development: A 20-year perspective","volume":"69","author":"Hutson","year":"2003","journal-title":"Birth Defects Res. C Embryo Today"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1242\/dev.127.8.1607","article-title":"Fate of the mammalian cardiac neural crest","volume":"127","author":"Jiang","year":"2000","journal-title":"Development"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ydbio.2005.02.011","article-title":"Cardiac neural crest is necessary for normal addition of the myocardium to the arterial pole from the secondary heart field","volume":"281","author":"Waldo","year":"2005","journal-title":"Dev. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/978-0-387-46954-6_8","article-title":"Neural crest contribution to the cardiovascular system","volume":"589","author":"Brown","year":"2006","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5051","DOI":"10.1242\/dev.126.22.5051","article-title":"Key roles of retinoic acid receptors alpha and beta in the patterning of the caudal hindbrain, pharyngeal arches and otocyst in the mouse","volume":"126","author":"Dupe","year":"1999","journal-title":"Development"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1038\/s41467-019-09197-8","article-title":"A Hox-TALE regulatory circuit for neural crest patterning is conserved across vertebrates","volume":"10","author":"Parker","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"aal2913","DOI":"10.1126\/science.aal2913","article-title":"Gene bivalency at Polycomb domains regulates cranial neural crest positional identity","volume":"355","author":"Minoux","year":"2017","journal-title":"Science"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Roux, M., and Zaffran, S. (2016). Hox Genes in Cardiovascular Development and Diseases. J. Dev. Biol., 4.","DOI":"10.3390\/jdb4020014"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"192476","DOI":"10.1242\/dev.192476","article-title":"Hox genes in development and beyond","volume":"150","author":"Hubert","year":"2023","journal-title":"Development"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1161\/ATVBAHA.112.300539","article-title":"Embryological-origin-dependent differences in homeobox expression in adult aorta: Role in regional phenotypic variability and regulation of NF-kappaB activity","volume":"33","author":"Cheung","year":"2013","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_30","first-page":"5341","article-title":"Deciphering the emerging landscape of HOX genes in cardiovascular biology, atherosclerosis and beyond (Review)","volume":"53","author":"Zhou","year":"2024","journal-title":"Int. J. Mol. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.mam.2005.12.003","article-title":"RNA integrity and the effect on the real-time qRT-PCR performance","volume":"27","author":"Fleige","year":"2006","journal-title":"Mol. Asp. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/nar\/30.1.207","article-title":"Gene Expression Omnibus: NCBI gene expression and hybridization array data repository","volume":"30","author":"Edgar","year":"2002","journal-title":"Nucleic Acids Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Beinder, L., Faehrmann, N., Wachtveitl, R., Winterfeld, I., Hartner, A., Menendez-Castro, C., Rauh, M., Ruebner, M., Huebner, H., and Noegel, S.C. (2014). Detection of expressional changes induced by intrauterine growth restriction in the developing rat mammary gland via exploratory pathways analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0100504"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"World Medical Association (2025). World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA, 333, 71\u201374.","DOI":"10.1001\/jama.2024.21972"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3250","DOI":"10.1074\/jbc.M110.157545","article-title":"Epigenomic reorganization of the clustered Hox genes in embryonic stem cells induced by retinoic acid","volume":"286","author":"Kashyap","year":"2011","journal-title":"J. Biol. Chem."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1038\/35039056","article-title":"Patterning the cranial neural crest: Hindbrain segmentation and Hox gene plasticity","volume":"1","author":"Trainor","year":"2000","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/75578","article-title":"Mutations in TFAP2B cause Char syndrome, a familial form of patent ductus arteriosus","volume":"25","author":"Satoda","year":"2000","journal-title":"Nat. Genet."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.ydbio.2010.02.001","article-title":"Targeted deletion of Hand2 in cardiac neural crest-derived cells influences cardiac gene expression and outflow tract development","volume":"341","author":"Holler","year":"2010","journal-title":"Dev. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.devcel.2009.10.006","article-title":"Moz and retinoic acid coordinately regulate H3K9 acetylation, Hox gene expression, and segment identity","volume":"17","author":"Voss","year":"2009","journal-title":"Dev. Cell"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"17911","DOI":"10.1073\/pnas.1318408111","article-title":"DNA methyltransferase 3B regulates duration of neural crest production via repression of Sox10","volume":"111","author":"Hu","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1101\/gr.249680.119","article-title":"Heterodimerization of TFAP2 pioneer factors drives epigenomic remodeling during neural crest specification","volume":"30","author":"Rothstein","year":"2020","journal-title":"Genome Res."},{"key":"ref_42","first-page":"1291","article-title":"Histochemical, immunohistochemical and ultrastructural analysis of aortic wall in neonatal coarctation","volume":"60","author":"Tanaskovic","year":"2019","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Seim, B.E., Holt, M.F., Ratajska, A., Michelsen, A., Ringseth, M.M., Halvorsen, B.E., Skjelland, M., Kvitting, J.P., Lundblad, R., and Krohg-Sorensen, K. (2022). Markers of extracellular matrix remodeling and systemic inflammation in patients with heritable thoracic aortic diseases. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.1073069"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.healun.2020.01.1338","article-title":"AAV-mediated TIMP-1 overexpression in aortic tissue reduces the severity of allograft vasculopathy in mice","volume":"39","author":"Remes","year":"2020","journal-title":"J. Heart Lung Transplant."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Seppelt, P.C., Schwill, S., Weymann, A., Arif, R., Weber, A., Zaradzki, M., Richter, K., Ensminger, S., Robinson, P.N., and Wagner, A.H. (2016). Loss of Endothelial Barrier in Marfan Mice (mgR\/mgR) Results in Severe Inflammation after Adenoviral Gene Therapy. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0148012"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Irqsusi, M., Dong, L.A., Rodepeter, F.R., Ramzan, R., Talipov, I., Ghazy, T., Gunther, M., Vogt, S., and Rastan, A.J. (2024). The Role of Matrix Metalloproteinases in Thoracic Aortic Disease: Are They Indicators for the Pathogenesis of Dissections?. Biomedicines, 12.","DOI":"10.20944\/preprints202401.2134.v1"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"111899","DOI":"10.1016\/j.biopha.2021.111899","article-title":"The paradoxical role of matrix metalloproteinase-11 in cancer","volume":"141","author":"Ma","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s12576-016-0512-x","article-title":"Pathology and molecular mechanisms of coarctation of the aorta and its association with the ductus arteriosus","volume":"67","author":"Yokoyama","year":"2017","journal-title":"J. Physiol. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.jacc.2006.10.057","article-title":"Vascular remodeling after \u201csuccessful\u201d repair of coarctation: Impact of aortic arch geometry","volume":"49","author":"Ou","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC Guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"4245","DOI":"10.1242\/dev.02610","article-title":"Myocardin is a direct transcriptional target of Mef2, Tead and Foxo proteins during cardiovascular development","volume":"133","author":"Creemers","year":"2006","journal-title":"Development"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"14598","DOI":"10.1074\/jbc.M111.329268","article-title":"Yap1 protein regulates vascular smooth muscle cell phenotypic switch by interaction with myocardin","volume":"287","author":"Xie","year":"2012","journal-title":"J. Biol. Chem."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"11642","DOI":"10.1038\/ncomms11642","article-title":"Context-dependent switch in chemo\/mechanotransduction via multilevel crosstalk among cytoskeleton-regulated MRTF and TAZ and TGFbeta-regulated Smad3","volume":"7","author":"Speight","year":"2016","journal-title":"Nat. Commun."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jash.2008.09.002","article-title":"Vascular Smooth Muscle Cell Signaling Mechanisms for Contraction to Angiotensin II and Endothelin-1","volume":"3","author":"Wynne","year":"2009","journal-title":"J. Am. Soc. Hypertens."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s00018-011-0815-2","article-title":"Cyclic nucleotide-dependent relaxation pathways in vascular smooth muscle","volume":"69","author":"Morgado","year":"2012","journal-title":"Cell Mol. Life Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e390","DOI":"10.1097\/CCM.0000000000001425","article-title":"Platelet-Derived Growth Factor Receptor-beta Regulates Vascular Smooth Muscle Cell Phenotypic Transformation and Neuroinflammation After Intracerebral Hemorrhage in Mice","volume":"44","author":"Yang","year":"2016","journal-title":"Crit. Care Med."},{"key":"ref_57","unstructured":"Schr\u00fcfer, P.N.F. (2018). Konotrunkale Defekte\u2014Unterschiedliche Genexpression im Aortengewebe von Neugeborenen, Friedrich-Alexander-Universit\u00e4t Erlangen N\u00fcrnberg-Erlangen."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5214\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:23:30Z","timestamp":1783416210000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":57,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15135214"],"URL":"https:\/\/doi.org\/10.3390\/jcm15135214","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}