Of note, the WTC dust was found to affect gene expression that could influence a variety of heart/cardiovascular functions, including coronary artery disease, heart development, cardiac fibrosis, myocardial hypertrophy, myocardial infarct, heart failure, etc. The WTC dust effect in the presence of potential ISO–WTC dust interactions could potentially impact the myocardial energy metabolism via PPAR signaling and heart valve development. The gene discussed is PPARA; the disease is heart failure.