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Circulating ketone bodies and mortality in heart failure: a community cohort study

Rebecca O Oyetoro1, Katherine M Conners1, Jungnam Joo2

  • 1Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States.

Frontiers in Cardiovascular Medicine
|February 8, 2024
PubMed

Insights

Ketone bodies (KB) are linked to increased mortality risk in heart failure (HF) patients, especially those with preserved ejection fraction. This study clarifies KB distribution and its association with HF progression and survival outcomes.

Area of Science:

  • Cardiology
  • Metabolic Research
  • Clinical Investigation

Background:

  • The prognostic significance of ketone bodies (KB) in heart failure (HF) remains unclear.
  • Understanding KB levels can offer new insights into HF pathophysiology and patient outcomes.

Purpose of the Study:

  • To determine KB distribution in a heart failure cohort.
  • To identify clinical factors associated with KB levels.
  • To investigate the relationship between plasma KB and all-cause mortality in HF patients.

Main Methods:

  • Plasma KB levels were quantified using nuclear magnetic resonance spectroscopy.
  • Multivariable linear regression analyzed associations between clinical factors and KB.
  • Proportional hazard regression assessed the link between KB and mortality, adjusting for covariates.

Main Results:

  • Higher KB levels correlated with advanced HF (NYHA class III-IV) and elevated NT-proBNP.
  • Increased KB levels were independently associated with a higher risk of all-cause mortality (HR 1.23).
  • This association was more pronounced in patients with preserved ejection fraction.

Conclusions:

  • Most heart failure patients had KB levels comparable to healthy individuals, but elevated levels indicated advanced disease.
  • Higher ketone body levels signify an increased mortality risk in heart failure, particularly in the preserved ejection fraction subgroup.
Abstract

Keywords:
biomarkersepidemiologyheart failureketone bodiesmortality

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