AKT1 and Myocardial fibrosis: It was found that miR-494-3p carried by CMs-derived exosomes could inhibit phosphatase and tensin homolog deleted on chromosome ten (PTEN) expresses and activates AKT/Smad2/3/ERK signaling pathway to regulate FBs activation, which is closely related to the occurrence and development of myocardial fibrosis induced by stress overload, and specific inhibition of miR-494-3p in myocardial tissue can significantly reverse this pathological process (Tang, 2020).