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Cardiovascular Effe...
Cardiovascular Effects of Treatment With the Ketone Body 3-Hydroxybutyrate in Chronic Heart Failure Patients
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- Nielsen, Roni (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark;Aarhus Univ Hosp, Dept Endocrinol & Metab, Aarhus, Denmark
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- Møller, Niels (författare)
- Aarhus Univ Hosp, Dept Endocrinol & Metab, Aarhus, Denmark;Aarhus Univ, Dept Clin Med, Fac Hlth, Aarhus, Denmark
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- Gormsen, Lars C. (författare)
- Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark;Aarhus Univ, Dept Clin Med, Fac Hlth, Aarhus, Denmark
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- Tolbod, Lars Poulsen (författare)
- Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark
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- Hansson, Nils Henrik (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark
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- Sörensen, Jens (författare)
- Uppsala universitet,Radiologi,Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark
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- Harms, Hendrik Johannes (författare)
- Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark
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- Frøkiaer, Jørgen (författare)
- Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark
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- Eiskjaer, Hans (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark
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- Jespersen, Nichlas Riise (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark;Aarhus Univ, Dept Clin Med, Fac Hlth, Aarhus, Denmark
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- Mellemkjaer, Soren (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark
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- Lassen, Thomas Ravn (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark;Aarhus Univ, Dept Clin Med, Fac Hlth, Aarhus, Denmark
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- Pryds, Kasper (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark;Aarhus Univ, Dept Clin Med, Fac Hlth, Aarhus, Denmark
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- Bøtker, Hans Erik (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark;Aarhus Univ, Dept Clin Med, Fac Hlth, Aarhus, Denmark
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- Wiggers, Henrik (författare)
- Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark;Aarhus Univ, Dept Clin Med, Fac Hlth, Aarhus, Denmark
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(creator_code:org_t)
- LIPPINCOTT WILLIAMS & WILKINS, 2019
- 2019
- Engelska.
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Ingår i: Circulation. - : LIPPINCOTT WILLIAMS & WILKINS. - 0009-7322 .- 1524-4539. ; 139:18, s. 2129-2141
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Myocardial utilization of 3-hydroxybutyrate (3-OHB) is increased in patients with heart failure and reduced ejection fraction (HFrEF). However, the cardiovascular effects of increased circulating plasma-3-OHB levels in these patients are unknown. Consequently, the authors' aim was to modulate circulating 3-OHB levels in HFrEF patients and evaluate: (1) changes in cardiac output (CO); (2) a potential doseresponse relationship between 3-OHB levels and CO; (3) the impact on myocardial external energy efficiency (MEE) and oxygen consumption (MVO 2); and (4) whether the cardiovascular response differed between HFrEF patients and age-matched volunteers.METHODS: Study 1: 16 chronic HFrEF patients (left ventricular ejection fraction: 37 +/- 3%) were randomized in a crossover design to 3-hour of 3-OHB or placebo infusion. Patients were monitored invasively with a Swan-Ganz catheter and with echocardiography. Study 2: In a doseresponse study, 8 HFrEF patients were examined at increasing 3-OHB infusion rates. Study 3 to 4: 10 HFrEF patients and 10 age-matched volunteers were randomized in a crossover design to 3-hour 3-OHB or placebo infusion. MEE and MVO 2 were evaluated using 11C-acetate positron emission tomography.RESULTS: 3-OHB infusion increased circulating levels of plasma 3-OHB from 0.4 +/- 0.3 to 3.3 +/- 0.4 mM (P< 0.001). CO rose by 2.0 +/- 0.2 L/min (P< 0.001) because of an increase in stroke volume of 20 +/- 2 mL (P< 0.001) and heart rate of 7 +/- 2 beats per minute (bpm) (P< 0.001). Left ventricular ejection fraction increased 8 +/- 1% (P< 0.001) numerically. There was a dose-response relationship with a significant CO increase of 0.3 L/min already at plasma-3-OHB levels of 0.7 mM (P< 0.001). 3-OHB increased MVO 2 without altering MEE. The response to 3-OHB infusion in terms of MEE and CO did not differ between HFrEF patents and age-matched volunteers.CONCLUSIONS: 3-OHB has beneficial hemodynamic effects in HFrEF patients without impairing MEE. These beneficial effects are detectable in the physiological concentration range of circulating 3-OHB levels. The hemodynamic effects of 3-OHB were observed in both HFrEF patients and age-matched volunteers. 3-OHB may potentially constitute a novel treatment principle in HFrEF patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- 3-hydroxybutyrate
- echocardiography
- heart failure
- ketone bodies
- metabolism
- positron-emission tomography
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Nielsen, Roni
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Møller, Niels
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Gormsen, Lars C.
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Tolbod, Lars Pou ...
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Hansson, Nils He ...
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Sörensen, Jens
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Harms, Hendrik J ...
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Frøkiaer, Jørgen
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Eiskjaer, Hans
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Jespersen, Nichl ...
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Mellemkjaer, Sor ...
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Lassen, Thomas R ...
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Pryds, Kasper
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Bøtker, Hans Eri ...
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Wiggers, Henrik
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