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[] This SIRT1 dysfunction results in increased acetylation of PGC-1, impairing its ability to activate the transcription of genes essential for mitochondrial biogenesis and oxidative phosphorylation, leading to mitochondrial dysfunction and bioenergetic deficiency, which directly contribute to cardiomyocyte death, pathological remodeling, dilated cardiomyopathy, and HF

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Thus, cooling tower blowdown constitutes the major discharge