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Strong evidence suggested that mitochondrial dysfunction\u2010induced myocardial oxidative stress is involved in the subcellular pathogenesis of acute ACM. We investigated whether astaxanthin (AST), an antioxidant lutein carotenoid, prevents acute ACM and explored the underlying mechanisms. C57BL\/6J mice were used to model ethanol\u2010induced ACM and were treated with AST (100\u2009mg\/kg\/day) alongside the autophagy inhibitor, 3\u2010methyladenine (10\u2009mg\/kg\/day). Cardiac function, heart pathology, cardiac hypertrophy, cardiomyocyte apoptosis, oxidative stress and mitochondrial function were evaluated, respectively in response to ethanol and\/or AST. The in\u00a0vivo study showed that ethanol\u2010induced cardiac dysfunction, morphological injury, cardiomyocyte apoptosis and oxidative stress were mitigated by AST. AST's anti\u2010apoptotic effects against ethanol were confirmed in\u00a0vitro. Ethanol\u2010induced cardiac apoptosis is closely associated with mitochondrial dysfunction which was attenuated by AST characterised by inhibiting fission and promoting fusion, as well as maintaining stable mitochondrial membrane potential, increased ATP production, enhanced biogenesis and restored mitophagy. Autophagy inhibition suppressed AST\u2010induced myocardial protection, indicating that myocardial mitophagy mediates AST effects. The present study demonstrates that AST induces cardiac protection against acute ACM by improving cardiac function, reducing pathological changes, and inhibiting oxidative stress, inflammation and apoptosis through preserved myocardial mitophagy\u2010mediated mitochondrial homeostasis.<\/jats:p>","DOI":"10.1111\/jcmm.70714","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T03:59:48Z","timestamp":1752465588000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Astaxanthin Prevented Acute Alcoholic Cardiomyopathy by Maintenance of Mitophagy\u2010Mediated Mitochondrial Homeostasis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1612-054X","authenticated-orcid":false,"given":"Guoyong","family":"Fan","sequence":"first","affiliation":[{"name":"Wenzhou Key Laboratory for the Diagnosis and Prevention of Diabetic Complications, the Third Affiliated 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