Immune activation and suppression are important factors influencing the recovery of cardiomyopathy-injured tissues, and a recent study by Dashuai Zhu et al. demonstrated that direct cardiac injection of MSCs-derived EVs induced the activation of Forkhead box protein O3 (Foxo3) and promoted the expression of IL-10, IL33, and IL34 through protein phosphatase (PP)-2A/p-Akt/Foxo3 pathway, and greatly ameliorated the differentiation of Tregs from T cells. This evidence concerns the gene FOXO3 and cardiomyopathy.