Cardiovascular Research Centre, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Nat Cardiovasc Res. 2023 May;2(5):425-437. doi: 10.1038/s44161-023-00259-1. Epub 2023 Apr 10.
Ketone bodies, the main one being β-hydroxybutyrate, have emerged as important regulators of the cardiovascular system. In healthy individuals, as well as in individuals with heart failure or post-myocardial infarction, ketones provide a supplemental energy source for both the heart and the vasculature. In the failing heart, this additional energy may contribute to improved cardiac performance, whereas increasing ketone oxidation in vascular smooth muscle and endothelial cells enhances cell proliferation and prevents blood vessel rarefication. Ketones also have important actions in signaling pathways, posttranslational modification pathways and gene transcription; many of which modify cell proliferation, inflammation, oxidative stress, endothelial function and cardiac remodeling. Attempts to therapeutically increase ketone delivery to the cardiovascular system are numerous and have shown mixed results in terms of effectiveness. Here we review the bioenergetic and signaling effects of ketones on the cardiovascular system, and we discuss how ketones can potentially be used to treat cardiovascular diseases.
酮体，主要是β-羟丁酸，已成为心血管系统的重要调节剂。在健康个体以及心力衰竭或心肌梗死后的个体中，酮体为心脏和血管系统提供了额外的能量来源。在衰竭的心脏中，这种额外的能量可能有助于改善心脏功能，而增加血管平滑肌和内皮细胞中的酮体氧化则增强细胞增殖并防止血管稀疏。酮体在信号通路、翻译后修饰途径和基因转录中也具有重要作用；其中许多作用可调节细胞增殖、炎症、氧化应激、内皮功能和心脏重构。目前有许多试图通过治疗增加酮体向心血管系统输送的方法，但在有效性方面的结果不一。本文综述了酮体对心血管系统的生物能量学和信号作用，并讨论了酮体如何潜在地用于治疗心血管疾病。
