In this study, we employed a left anterior descending coronary artery (LADCA) ligation-induced HF rat model and an in vitro hypoxia-reoxygenation (H/R)-stimulated H9C2 cardiomyocyte model to delve into the potential mechanism of tanshinone IIA in hindering myocardial pyroptosis and ameliorating HF and cardiac remodeling via the TLR4/NF-κB p65 pathway. The gene discussed is NFKB1; the disease is hydrops fetalis.