Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Am Soc Echocardiogr. 2022 Mar;35(3):305-311. doi: 10.1016/j.echo.2021.10.017. Epub 2021 Nov 17.
Interest in therapeutic applications of exogenous ketones has grown significantly, spanning patients with heart failure to endurance athletes. Exogenous ketones engender significant effects on cardiac function in heart failure and provide an ergogenic benefit in athletes. The aim of this study was to assess the effects of exogenous ketones on cardiac function in healthy participants.
In a single-arm intervention study, 20 fasting, healthy participants underwent comprehensive echocardiography (two-dimensional, Doppler, and strain) before and 30 min after weight-based oral ketone ester administration. The relationship between changes in log-transformed biomarker levels and change in absolute global longitudinal strain (GLS) was assessed using linear regression.
The mean age was 30 ± 7 years, 50% were women, 45% were nonwhite, and the average body mass index was 24.3 ± 3.1 kg/m. Ketone ingestion acutely elevated β-hydroxybutyrate levels from a median of 0.13 mmol/L (interquartile range, 0.10-0.37 mmol/L) to 3.23 mmol/L (interquartile range, 2.40-4.97 mmol/L) (P < .001). After ketone ester consumption, systolic blood pressure, heart rate, biventricular function, left ventricular GLS, and left atrial (LA) strain all augmented, while systemic vascular resistance decreased. Displayed as mean change, increases in ejection fraction (3.1%; 95% CI, 2.0%-4.2%; P < .001), GLS (2.0%; 95% CI, 1.4%-2.7%; P < .001), right ventricular S' (1.1 cm/sec; 95% CI, 0.4-1.8 cm/sec; P = .004), LA reservoir strain (7%; 95% CI, 3%-12%; P = .005), and LA contractile strain (4%; 2%-6%; P = .001) were observed. During robustly achieved ketosis, change in GLS was inversely associated with change in nonesterified fatty acids (P = .019).
In a single-arm study, systolic blood pressure, heart rate, biventricular function, and LV and LA strain acutely augmented after ketone ester ingestion in healthy, fasting participants, similar to several effects observed in the failing heart. These data may provide supporting data for the ergogenic benefits observed in athletes and may become increasingly relevant with exogenous ketone consumption across a variety of cardiovascular and noncardiovascular applications.
外源性酮体在治疗中的应用兴趣显著增加，涵盖了心力衰竭患者和耐力运动员。外源性酮体对心力衰竭患者的心脏功能有显著影响，并为运动员提供了有益的作用。本研究旨在评估外源性酮体对健康参与者心脏功能的影响。
在一项单臂干预研究中，20 名禁食的健康参与者在口服酮酯后 30 分钟内进行了全面的超声心动图（二维、多普勒和应变）检查。使用线性回归评估经对数转换的生物标志物水平变化与绝对整体纵向应变（GLS）变化之间的关系。
参与者的平均年龄为 30 ± 7 岁，50%为女性，45%为非白人，平均体重指数为 24.3 ± 3.1kg/m。酮的摄入使β-羟基丁酸水平从中位数 0.13mmol/L（四分位距，0.10-0.37mmol/L）升高至 3.23mmol/L（四分位距，2.40-4.97mmol/L）（P<0.001）。酮酯摄入后，收缩压、心率、双心室功能、左心室 GLS 和左心房（LA）应变均增加，而全身血管阻力降低。以平均值变化表示，射血分数（3.1%；95%CI，2.0%-4.2%；P<0.001）、GLS（2.0%；95%CI，1.4%-2.7%；P<0.001）、右心室 S'（1.1cm/sec；95%CI，0.4-1.8cm/sec；P=0.004）、LA 储备应变（7%；95%CI，3%-12%；P=0.005）和 LA 收缩应变（4%；2%-6%；P=0.001）均有增加。在酮症的显著状态下，GLS 的变化与非酯化脂肪酸的变化呈负相关（P=0.019）。
在一项单臂研究中，健康的禁食参与者在摄入酮酯后，收缩压、心率、双心室功能以及左心室和左心房应变均急性增加，与心力衰竭患者的多种影响相似。这些数据可能为运动员观察到的有益作用提供支持数据，并且随着外源性酮体在各种心血管和非心血管应用中的使用，这些数据可能会变得越来越重要。
