However, more work will be needed to determine the role of SIRT1 and FOXO3a in miR-34a-mediated functions in myocardial ischemia in vivo and to investigate whether other signaling pathways such as NOTCH signaling pathways, which have been reported to be regulated by miR-34a [57], are involved in the H/SD process in MSCs. Here, FOXO3 is linked to myocardial ischemia.