“Puerarin, as the main flavonoid active ingredient in traditional Chinese medicine Pueraria lobata, has multidimensional pharmacological effects such as vasodilation, regulation of neuroendocrine balance, improvement of metabolic homeostasis, and inhibition of myocardial apoptosis. This review systematically integrates the multi-target regulatory network of puerarin, elucidating its mechanisms of improving energy metabolism through the adenosine monophosphate activated protein kinase/mammalian rapamycin target protein (AMPK/mTOR) signaling pathway, inhibiting fibrosis mediated by transforming growth factor - β (TGF - β)/Smad signaling, and regulating the nuclear factor E2 related factor 2/nuclear transcription factor kappa B (Nrf2/NF - κ B) axis to alleviate oxidative inflammatory responses; At the same time, combined with clinical research data, verify its therapeutic potential in improving left ventricular ejection function and reducing the risk of cardiovascular events.”