Fig. 7.

A schematic diagram of the potential therapeutic strategies based on exercise-regulated signaling pathways. Pharmacological therapy and gene therapy can target exercise-regulated signaling pathways (e.g., IGF1/PI3K/AKT, C/EBPβ/CITED4, noncoding RNAs, HIPK2, and ADAR2) to exert cardioprotective effect. Meanwhile, exercise-regulated small extracellular vesicles and gut microbiota as well as related metabolites can be applied to be potential therapeutic strategies for myocardial injury. IGF1 insulin growth factor 1, IGFR1 insulin growth factor 1 receptor, PI3K phosphoinositide-3 kinase, AKT protein kinase B, C/EBPβ CCAAT/enhancer binding protein β, SRF serum response factor, CITED4 CBP/p300-interacting transactivator with ED-rich carboxyterminal domain 4, HIPK2 homeodomain-interacting protein kinase 2, sEV small extracellular vesicles, 3-HPA 3-hydroxyphenylacetic acid, 4-HBA 4-hydroxybenzoic acid