The core mechanism of traditional Chinese medicine in improving myocardial fibrosis: restoring the dynamic balance of mitochondrial quality control.

Myocardial fibrosis (MF), characterized by excessive collagen deposition, represents an inevitable pathological progression toward end-stage heart disease, underscoring the urgent clinical need for effective reversal strategies. In recent years, the mitochondrial quality control (MQC) system has emerged as a central regulatory hub for maintaining cardiac homeostasis, offering novel insights into the prevention and treatment of MF. This review bridges classical Traditional Chinese Medicine (TCM) therapeutic concepts with modern MQC mechanisms, primarily aiming to evaluate the intervention targets and efficacy of TCM monomers and formulas by detecting alterations in mitochondrial-associated protein expression, gene transcription levels, and organelle ultrastructure. By systematically reviewing experimental evidence of TCM-mediated MQC modulation, this paper highlights the multi-target and systematic advantages of TCM in combating MF, thereby injecting new momentum into the development of contemporary anti-MF therapeutics.