Exogenous ketone therapy for heart failure: A review

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Abstract

Heart failure is of major clinical and economic importance and remains a major public health problem worldwide. Despite existing treatment approaches, morbidity and mortality in these patients remains high. The progression of heart failure is accompanied by an increase in the metabolism of ketone bodies. The use of exogenous ketones may become a new therapeutic approach to increase cardiac efficiency, reduce energy deficit and improve cardiac function in patients with heart failure. The review presents the available data on ketone body metabolism in patients with heart failure, preclinical and clinical studies demonstrating the beneficial effects of exogenous ketone therapy in animal models and human studies with heart failure, and describes the potential pros and cons of using this therapeutic approach.

About the authors

Yulia O. Aksenova

Chazov National Medical Research Center of Cardiology

Email: bonisana@mail.ru
ORCID iD: 0000-0002-6546-2535

Medical Resident

Russian Federation, Moscow

Yulia F. Osmolovskaya

Chazov National Medical Research Center of Cardiology

Email: bonisana@mail.ru
ORCID iD: 0000-0002-7827-2618

Department Head

Russian Federation, Moscow

Igor V. Zhirov

Chazov National Medical Research Center of Cardiology; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: izhirov@mail.ru
ORCID iD: 0000-0002-4066-2661

D. Sci. (Med.)

Russian Federation, Moscow; Moscow

Allan G. Beniashvili

Mental Health Science Center

Email: izhirov@mail.ru
ORCID iD: 0000-0002-5149-3760

Cand. Sci. (Med.)

Russian Federation, Moscow

Margarita A. Morozova

Mental Health Science Center

Email: izhirov@mail.ru
ORCID iD: 0000-0002-7847-2716

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Sergey N. Tereshchenko

Chazov National Medical Research Center of Cardiology

Email: izhirov@mail.ru
ORCID iD: 0000-0001-9234-6129

D. Sci. (Med.), Prof.

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. The main ways of ATP production in cardiomyocytes.

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3. Fig. 2. Formation of ketone bodies in the liver.

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4. Fig. 3. Changes in energy metabolism in the myocardium in heart failure.

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