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The pathological process of cardiac remodeling, which involves alterations in the structure and function of the heart, is a major way that TMAO aggravates these effects [77]

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At the same time, Akt phosphorylates and inactivates forkhead box O (FoxO), thereby inhibit the responsible for proteolysis ubiquitin ligases: muscle-specific RING finger-1 (MuRF-1) and muscle atrophy F-box protein (atrogin-1), (for review see [2729])