Figure 8: Schematic model depicting miR-146a regulation of SUMOylation in heart failure. During heart failure, miR-146a is expressed and processed in fibroblasts. The mature miR-146a is secreted as an EV-associated form from the activated fibroblasts and then transferred into cardiomyocytes. The fibroblast-derived miR-146a targets SUMO1 and attenuates SERCA2a SUMOylation, thus reducing cardiomyocyte function.