Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, 833 Chestnut Street, Suite 600, Philadelphia, PA, 19107, USA.
Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Curr Heart Fail Rep. 2024 Oct;21(5):498-503. doi: 10.1007/s11897-024-00678-6. Epub 2024 Sep 7.
The development and progression of heart failure is characterized by metabolic and physiologic adaptations allowing patients to cope with cardiac insufficiency. This review explores the changes in metabolism in heart failure and the potential role of biomarkers, particularly ketone bodies, in staging and prognosticating heart failure progression.
Recent insights into myocardial metabolism shed light on the heart's response to stress, highlighting the shift towards reliance on ketone bodies as an alternative fuel source. Elevated blood ketone levels have been shown to correlate with the severity of cardiac dysfunction, emphasizing their potential as prognostic indicators. Furthermore, studies exploring therapeutic interventions targeting specific metabolic pathways offer promise for improving outcomes in heart failure. Ketones have prognostic utility in heart failure, and potentially, an avenue for therapeutic intervention. Challenges remain in deciphering the optimal balance between metabolic support and exacerbating cardiac remodeling. Future research endeavors must address these complexities to advance personalized approaches in managing heart failure.
心力衰竭的发展和进展以代谢和生理适应为特征，使患者能够应对心脏功能不全。本综述探讨了心力衰竭代谢的变化以及生物标志物（特别是酮体）在心力衰竭分期和预后中的潜在作用。
最近对心肌代谢的深入了解揭示了心脏对压力的反应，强调了对酮体作为替代燃料来源的依赖转变。已证明血液酮体水平升高与心脏功能障碍的严重程度相关，强调了它们作为预后指标的潜力。此外，探索针对特定代谢途径的治疗干预措施的研究为改善心力衰竭的预后提供了希望。酮体在心力衰竭中有预后作用，并且有可能成为治疗干预的途径。在解读代谢支持与加重心脏重构之间的最佳平衡方面仍然存在挑战。未来的研究工作必须解决这些复杂性，以推进心力衰竭管理的个性化方法。
