Crossover Trial of Exogenous Ketones on Cardiometabolic Endpoints in Heart Failure With Preserved Ejection Fraction

作者：Senthil Selvaraj, Antoneta Karaj, Julio A. Chirinos, Nicole Denney, Gabby Grosso, Melissa Fernando, K. C. Chambers, Cassandra Demastus, Ravinder Reddy, Michael C. Langham, Dushyant Kumar, Hannah Maynard, Bianca Pourmussa, Stuart B. Prenner, Jordana B. Cohen, Harry Ischiropoulos, Michael R. Rickels, David C. Poole, David D. Church, Robert R. Wolfe, Daniel P. Kelly, Mary Putt, Kenneth B. Margulies, Payman Zamani · 发表于：JACC Heart Failure · 年份：2025 · DOI：10.1016/j.jchf.2025.03.002 · 被引用次数：7 · 研究领域：Diet and metabolism studies、Cardiovascular and exercise physiology、Cardiovascular Function and Risk Factors

BACKGROUND: The etiology of exercise intolerance in heart failure with preserved ejection fraction (HFpEF) is multifactorial. Several contributing pathways may be improved by ketone ester (KE). OBJECTIVES: This study aims to determine whether KE improves exercise tolerance in HFpEF. METHODS: ) during incremental cardiopulmonary exercise testing and time to exhaustion during an additional constant-intensity exercise (75% peak workload) bout. RESULTS: -glucose infusions during constant-intensity exercise, plasma glucose appearance rate before and during exercise was lower with KE (-0.24 mg/kg/min; P < 0.001). During both exercise protocols, KE lowered: 1) respiratory exchange ratios, demonstrating decreased systemic carbohydrate use; 2) nonesterified fatty acids and glucose; and 3) estimated left ventricular filling pressures (E/e'). CONCLUSIONS: or constant-intensity exercise in HFpEF. (Ketogenic Exogenous Therapies in HFpEF [KETO-HFpEF]; NCT04633460).