Notably, in the setting of Dox-related cardiomyopathy, increased Sirt1 expression is closely associated with enhanced PGC1α activity, which promotes mitochondrial biogenesis and fatty acid oxidation, resulting in improved cardiomyocyte metabolism, decreased myocardial fibrosis, and restored heart function 51. Here, PPARGC1A is linked to Myocardial fibrosis.