Higher expression of vascular endothelial growth factor (VEGF)/VEGF receptor expression of endothelium,22 nestin positive, which is a marker for newly formed endothelial cell, in the affected vessels,22,23 increased the number of circulating endothelial progenitor cells,24 and smooth muscle cell (SMC) proliferation and migration and inflammatory processes are known to be associated with MMD development. The gene discussed is VEGFA; the disease is multiminicore myopathy.