VEGFA and hydrops fetalis: While many animal studies have set out to explore how experimentally induced DM impacts upon cardiac gene expression, few human studies have addressed this issue, largely because of the challenge of accessing tissue, especially from the LV.25 The largest published analysis of DM-associated LV gene expression profiles was conducted by Liu et al., who compared seven people with type 2 DM and HF against 12 controls with only HF.10 They identified focal adhesions, vascular endothelial growth factor signalling, and mitogen-activated protein kinase signalling in pathway analyses.