Crabtree Christopher D, Buga Alex, Han Yuchi, Simonetti Orlando P, Volek Jeff S
Department of Radiology, The Ohio State University, Columbus, OH, USA.
Department of Human Sciences, The Ohio State University, Columbus, OH, USA.
Curr Atheroscler Rep. 2025 Aug 28;27(1):85. doi: 10.1007/s11883-025-01333-8.
We provide an overview of cardiac metabolism, ketone physiology and terminology, methods of elevating ketones and their effect on cardiac function and disease. We discuss future research directions and speculate what ketogenic strategies may yield optimal effects on the heart and cardiovascular disease.
Nutritional ketosis acutely elevates cardiac function (cardiac output, myocardial perfusion, etc.) in healthy people and those with cardiovascular disease in a dose-dependent manner between circulating ketones and cardiac function. Despite therapeutic potential, long-term studies have not been performed. This acute effect is rapid, dose-dependent, and has been seen to be durable for up to 14 days following intervention onset. There are numerous methods to elicit ketogenesis and promote nutritional ketosis. There is growing evidence to suggest that higher ketone levels may offer greater cardiac benefits. It is pertinent to consider what ketone levels to target, and the best methods to safely and feasibly reach those targets over sustained periods of time.
我们概述了心脏代谢、酮体生理学和术语、提高酮体的方法及其对心脏功能和疾病的影响。我们讨论了未来的研究方向，并推测生酮策略可能对心脏和心血管疾病产生何种最佳效果。
在健康人和患有心血管疾病的人群中，营养性酮症可使心脏功能（心输出量、心肌灌注等）急性升高，且循环酮体与心脏功能之间呈剂量依赖性。尽管具有治疗潜力，但尚未进行长期研究。这种急性效应迅速、呈剂量依赖性，且在干预开始后长达14天内都能持续存在。引发酮体生成和促进营养性酮症的方法有很多。越来越多的证据表明，较高的酮体水平可能对心脏有更大益处。考虑将何种酮体水平作为目标，以及在较长时间内安全可行地达到这些目标的最佳方法是很有必要的。
