[25–27] Published studies in adults show that MMP-7 levels are elevated in patients with pulmonary arterial hypertension compared to controls and suggest MMP-7 may play a role in early differentiation of pulmonary artery hypertension from other causes of dyspnea.[28] In older pediatric patients with CHD, serum metalloproteinases have been associated pulmonary arterial stiffness and ventricular dysfunction.[26]. This evidence concerns the gene MMP7 and coronary artery disorder.