Furthermore, in cardiogenic NEC, microcirculatory changes in CHD patients with altered hemodynamics compared to normal infants may contribute by altered cross talk of intrinsic endothelin-1 (vasoconstrictor) and nitric oxide (vasodilator), which has been shown in animal models demonstrating a maladaptive vasoconstriction to compensate for postoperative arterial hypotension and hypoxemia (23, 24). Here, EDN1 is linked to coronary artery disorder.