Swine at age 6 weeks were given four weeks of high fat and high cholesterol diet to induce metabolic syndrome. An ameroid constrictor was placed on the proximal left circumflex artery to induce chronic myocardial ischemia. Two weeks later, animals received intramyocardial injection of either saline vehicle (“control”) or extracellular vesicles (high fat diet with myocardial EV injection group “HVM”). Five weeks later myocardial tissue was harvested for analysis. Ischemic myocardium in the HVM group had decreased expression of pro-inflammatory signaling markers NFκB, pro-IL1ß, and CD11c, and increased expression of anti-inflammatory markers IL-10 and CD163. EV = extracellular vesicle. In boxplots, upper and lower borders of box represent upper and lower quartiles, middle horizontal line represents median, upper and lower whiskers represent maximum and minimum values of non-outliers.