Although the transcriptome profile of the heart during development, in fetuses with chromosome 21 trisomy, has been shown to be characterized by a significant increase in expression of RUNX1 and many ECM genes (Conti et al., 2007), the demonstration that in hearts of fetuses that develop CHD the increase in expression is higher than in those that do not develop CHD is still missing. Here, RUNX1 is linked to coronary artery disorder.