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The hydrogel was prepared and characterized, and its effects on cardiomyocyte survival, proliferation, migration, and tube formation were evaluated using in\u00a0vitro models. In\u00a0vivo experiments on a mouse myocardial infarction model demonstrated improved cardiac function and decreased incidence of arrhythmias after treatment with the hydrogel. RNA sequencing and proteomics analyses highlighted the potential involvement of PI3K\/Akt\/mTOR, Hippo, TGF\u2010\u03b2, HIF\u20101, and FoxO pathways; mechanistic causality remains to be established. The findings are consistent with enhanced cardiomyocyte activities, increased expression of key proteins such as HIF\u20101\u03b1 and BNIP3, and remodeling of the myocardial microenvironment that may facilitate myocardial repair and functional recovery; these associations do not establish causality.<\/jats:p>","DOI":"10.1096\/fj.202501080rr","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T14:34:41Z","timestamp":1756218881000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Molecular Mechanisms of Myocardial Repair and Cardiac Function Improvement With Hydrogel\u2010Mediated Macrophage\u2010Derived Exosome Delivery"],"prefix":"10.1096","volume":"39","author":[{"given":"Ling","family":"Yuan","sequence":"first","affiliation":[{"name":"Operating Room The First Affiliated Hospital of Jinzhou Medical University  Jinzhou 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