This study suggests that ginsenoside Rb1 ameliorates myocardial energy metabolism and ventricular remodeling in HF by modulating the Twist1/PGC-1α/PPARα signaling pathway, specifically through inhibiting Twist1 expression while promoting the expression and activation of PGC-1α and its downstream target PPARα (Figure 9). Here, PPARA is linked to hydrops fetalis.