Thus, the decreased expression of calponin and SMMHC and increased expression of Notch3, Hes5, and PDGFR-β once again supports a shift towards a less differentiated, more proliferative vSMC phenotype potentially contributing to hypermuscularization of the pulmonary vasculature in CDH. This evidence concerns the gene MYH11 and congenital diaphragmatic hernia.