PPARA and hydrops fetalis: This effect is thought to be partly mediated by activation of PPAR-α, which has been linked to various cardioprotective effects.32 Fenofibrate has also been found to alleviate HF by modulating fatty acid metabolism, which is often disrupted in HF.33 Additionally, fenofibrate has been shown to ameliorate endothelial expression of cell adhesion molecules, which are involved in the pathogenesis of HF.34