In cardiac muscle, NAD+ supports mitochondrial function and energy production while protecting against ischemic injury and age-related cardiac dysfunction
Recently, a senolytic peptide, fork head box O transcription factor 4-D-Retro-Inverso (FOXO4-DRI), was reported to selectively kill the senescent fibroblasts
This homogeneity likely supports cellular resilience, ensuring that fluctuations in redox state are uniformly sensed and managed across compartments
Mechanistic plausibility does not guarantee a predictable, beneficial outcome in a given patient, and clinicians should frame the combination as biologically interesting rather than clinically proven

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