Cardiolipin (CL), the signature phospholipid of the inner mitochondrial membrane, accounts for approximately 12–15% of cardiac phospholipids and is dominated by tetralinoleoyl species ((18:2)₄CL; approximately 80–90% linoleate) with highly conserved acyl symmetry in healthy mammalian hearts. This linoleate-rich CL supports electron transport chain organisation (complexes I/III/IV and their supercomplexes), proton handling, substrate transport, ATP synthase activity, cytochrome-c anchoring, protein import, mitochondrial dynamics, and lipid signalling.
