Although there have been significant advances in the treatment of heart failure in recent years

chronic heart failure remains a leading cause of cardiovascular disease-related death. Many studies have found that targeted cardiac metabolic remodeling has good potential for the treatment of heart failure. However

most of the drugs that increase cardiac energy are still in the theoretical or testing stage. Some research has found that botanical drugs not only increase myocardial energy metabolism through multiple targets but also have the potential to restore the balance of myocardial substrate metabolism. In this review

we summarized the mechanisms by which botanical drugs (the active ingredients/formulas/Chinese patent medicines) improve substrate utilization and promote myocardial energy metabolism by activating AMP-activated protein kinase (AMPK)

peroxisome proliferator-activated receptors (PPARs) and other related targets. At the same time

some potential protective effects of botanical drugs on myocardium

such as alleviating oxidative stress and dysbiosis signaling

caused by metabolic disorders

were briefly discussed.