Ketone ester lowered plasma glucose appearance rate before and during exercise by 0.24 mg/kg/min (P<0.001) and decreased estimated left ventricular filling pressures in patients with HFpEF.
RCT
Does ketone ester improve exercise tolerance in patients with heart failure with preserved ejection fraction?
Exogenous ketone ester alters metabolic substrate utilization and lowers estimated left ventricular filling pressures during exercise in patients with HFpEF.
Effect estimate: Difference -0.24 mg/kg/min
p-value: p=<0.001
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).
Selvaraj et al. (Mon,) conducted a rct in Heart failure with preserved ejection fraction (HFpEF). Ketone ester (KE) was evaluated on Plasma glucose appearance rate before and during exercise (Difference -0.24 mg/kg/min, p=<0.001). Ketone ester lowered plasma glucose appearance rate before and during exercise by 0.24 mg/kg/min (P<0.001) and decreased estimated left ventricular filling pressures in patients with HFpEF.