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Although hydralazine and its derivatives exhibit broad therapeutic efficacy, with repositioning potential ranging from cardiovascular care to oncology ( Consequently, while current data support the short-term tolerability of Meldonium, its long-term hepatic and mitochondrial safety profile, (especially in healthy athletes) requires more rigorous evaluation ( Athletic implications and controversies While regular moderate exercise is generally cardioprotective, chronic high-intensity training may promote irreversible mitochondrial dysfunction, impaired ATP synthesis, and systemic inflammation ( Such a mechanism seems unlikely to add any major benefit in healthy, highly trained athletes, who already display near-maximal PDH activation and finely tuned regulation of glycolytic flux under heavy exercise

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