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However, whether it confers protection through a right-ventricle (RV) myocardial metabolic mechanism is unknown.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Male Sprague\u2013Dawley rats were orally administrated with\n                      <jats:italic>BCW<\/jats:italic>\n                      , which was injected concurrently with a bolus of Sugen5416, and subjected to hypoxia exposure (SuHx; 5000\u00a0m altitude) for 4\u00a0weeks. Right ventricular hypertrophy (RVH) in high-altitude heart disease (HAHD) was assessed using Fulton\u2019s index (FI; ratio of RV to left ventricle\u2009+\u2009septum weights) and heart-weight-to-body-weight ratio (HW\/BW). The effect of therapeutic administration of\n                      <jats:italic>BCW<\/jats:italic>\n                      on the RVH hemodynamics was assessed through catheterization (mean right ventricular pressure and mean pulmonary artery pressure (mRVP and mPAP, respectively)). Tissue samples were used to perform histological staining, and confirmatory analyses of mRNA and protein levels were conducted to detect alterations in the mechanisms of RVH in HAHD. The protective mechanism of\n                      <jats:italic>BCW<\/jats:italic>\n                      was further verified via cell culture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>BCW<\/jats:italic>\n                      considerably reduced SuHx-associated RVH, as indicated by macro morphology, HW\/BW ratio, FI, mPAP, mRVP, hypertrophy markers, heart function, pathological structure, and myocardial enzymes. Moreover,\n                      <jats:italic>BCW<\/jats:italic>\n                      can alleviate the disorder of glucose and fatty acid metabolism through upregulation of carnitine palmitoyltransferase1\u0251, citrate synthase, and acetyl-CoA and downregulation of glucose transport-4, phosphofructokinase, and pyruvate, which resulted in the reduced levels of free fatty acid and lactic acid and increased aerobic oxidation. This process may be mediated via the regulation of sirtuin 3 (SIRT3)-hypoxia-inducible factor 1\u03b1 (HIF1\u03b1)-pyruvate dehydrogenase kinase (PDK)\/pyruvate dehydrogenase (PDH) signaling pathway. Subsequently, the inhibition of SIRT3 expression by 3-TYP (a selective inhibitor of SIRT3) can reverse substantially the anti-RVH effect of\n                      <jats:italic>BCW<\/jats:italic>\n                      in HAHD, as indicated by hypertrophy marker and serum myocardial enzyme levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>BCW<\/jats:italic>\n                      prevented SuHx-induced RVH in HAHD via the SIRT3-HIF1\u0251-PDK\/PDH signaling pathway to alleviate the disturbance in fatty acid and glucose metabolism. Therefore,\n                      <jats:italic>BCW<\/jats:italic>\n                      can be used as an alternative drug for the treatment of RVH in HAHD.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12906-024-04490-6","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T06:02:12Z","timestamp":1715752932000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Bawei Chenxiang Wan ameliorates right ventricular hypertrophy in rats with high altitude heart disease by SIRT3-HIF1\u03b1-PDK\/PDH signaling pathway improving fatty acid and glucose metabolism"],"prefix":"10.1186","volume":"24","author":[{"given":"Yiwei","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"key":"4490_CR1","doi-asserted-by":"crossref","unstructured":"Tremblay JC, Ainslie PN. 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