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Ginger-processed American ginseng (GPAG), a medicine-food homologous herb, exerts anti-inflammatory, antioxidant, and metabolic-regulatory effects; however, its cardioprotective mechanisms against ACE\/R remain unclear. An ACE\/R rat model was established by exposing rats to \u221215 \u00b0C for 6 h followed by 24 \u00b0C rewarming for 12 h, with 7-day GPAG gavage (1 and 2 g\/kg) prior to cold exposure. Integrated multiomics, fecal microbiota transplantation (FMT), and fecal metabolite\u2013cardiomyocyte intervention assays were employed to elucidate the gut-heart axis mechanism. GPAG ameliorated hemorheological disorders, restored cardiac dysfunction, and attenuated myocardial lesions. Mechanistically, GPAG remodels gut microbiota to generate functional metabolites that activate the myocardial AMPK\/PGC-1\u03b1\/PPAR\u03b1 pathway via the gut-heart axis, thereby optimizing cardiac energy metabolism and restoring mitochondrial homeostasis to alleviate ACE\/R-triggered myocardial damage.<\/jats:p>","DOI":"10.1021\/acs.jafc.6c04969","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:35:13Z","timestamp":1788327313000},"page":"27538-27562","source":"Crossref","is-referenced-by-count":0,"title":["Ginger-Processed American Ginseng Alleviates Myocardial\nInjury Induced by Acute Cold Exposure\/Rewarming by Remodeling Gut\nMicrobiota to Activate the AMPK\/PGC-1\u03b1\/PPAR\u03b1 Pathway"],"prefix":"10.1021","volume":"74","author":[{"given":"Shuting","family":"Feng","sequence":"first","affiliation":[{"name":"The First Hospital of Jilin University , , ,","place":["Changchun, China, 130021"]},{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"Fu","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4615-6943","authenticated-orcid":true,"given":"Huali","family":"Xu","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Ma","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1683-1602","authenticated-orcid":true,"given":"Dayun","family":"Sui","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Sui","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]},{"name":"Jilin BeiyuHong Pharmaceutical Co., Ltd. , ,","place":["Tonghua, China, 134100"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Xie","sequence":"additional","affiliation":[{"name":"Jilin BeiyuHong Pharmaceutical Co., Ltd. , ,","place":["Tonghua, China, 134100"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialin","family":"Chen","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbing","family":"Wu","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Cai","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunuo","family":"Liu","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linyu","family":"Li","sequence":"additional","affiliation":[{"name":"Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1493-5328","authenticated-orcid":true,"given":"Yan","family":"Xue","sequence":"additional","affiliation":[{"name":"The First Hospital of Jilin University , , ,","place":["Changchun, China, 130021"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"2026090917075815000_cit1","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jemermed.2025.09.030","article-title":"Effects of Cold Exposure\non Neurological Mortality of Out-of-Hospital Cardiac Arrest Patients","volume":"80","author":"Uechi","year":"2026","journal-title":"J. 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Master\u2019s Thesis, Jilin\nUniversity, 2017."},{"key":"2026090917075815000_cit26","unstructured":"Wang, H.\n          \n          Exploring the\nmaterial basis and potential mechanism ofginger-processed American\nginseng to improve diabetic nephropathybased on metabolomics and transcriptomics\ntechnology.  Master\u2019s Thesis, Jilin University, 2025."},{"issue":"7","key":"2026090917075815000_cit27","doi-asserted-by":"publisher","first-page":"3252","DOI":"10.1111\/1750-3841.15757","article-title":"Protective\neffects\nof ginsenoside Rc against acute cold exposure-induced myocardial injury\nin rats","volume":"86","author":"Xue","year":"2021","journal-title":"J. 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