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Clinically, TMZ improves systolic function and exercise tolerance without adverse hemodynamic effects, highlighting its potential as an adjunct therapy, especially in patients with impaired FAO ( Glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as semaglutide, enhance pyruvate entry into the TCA cycle and promote FAO, reducing lipid accumulation, preserving mitochondrial function, and attenuating cardiac remodeling in experimental models (Ma et al., 2024)