Ketone bodies improve myocardial blood flow and ejection fraction in healthy subjects and benefit cardiac output and left heart filling pressures in patients with decompensated heart failure.
Does exogenous ketone body supplementation improve myocardial blood flow and cardiac function in healthy subjects and patients with cardiovascular disease?
This review highlights the potential of ketone bodies to improve myocardial perfusion and cardiac function in both healthy individuals and patients with heart failure.
Ketone bodies (KBs) serve as an alternative energy source for healthy and failing hearts and have important effects on myocardial blood perfusion in both physiological and pathological states. Early animal studies suggest that KBs may provide protective benefits in ischemic heart disease and heart failure. Under normal circumstances, coronary blood flow regulation is an intricate system with contributions from metabolic, autonomic, compressive, and endothelial factors, with the metabolic regulatory pathway being the most significant contributor. We conducted a non-systematic review of studies published between 1987 and 2024. In this review, we explored the physiological autoregulation of normal coronary blood flow, the role of ketone bodies in myocardial perfusion in health and disease, and the potential role of exogenous ketone body supplementation in producing salutary effects on myocardial blood flow (MBF) and metabolism in exercise and cardiac disease states including ischemia, heart failure, and the aging heart. Overall, our findings demonstrated that KBs improve MBF and ejection fraction in healthy human subjects and have beneficial effects on cardiac output and left heart filling pressures in patients with decompensated heart failure. Although resting myocardial blood flow decreases with age, further studies are required to assess the impact of KBs on MBF in aging populations. Additionally, more research is needed to investigate the effects of KBs during exercise and in instances of myocardial ischemia.
Aromiwura et al. (Mon,) conducted a review in Cardiovascular disease, heart failure, and ischemia. Ketone bodies was evaluated on Myocardial blood flow and metabolism. Ketone bodies improve myocardial blood flow and ejection fraction in healthy subjects and benefit cardiac output and left heart filling pressures in patients with decompensated heart failure.