Key result
In patients undergoing cardiac surgery on cardiopulmonary bypass, circulating ketone body levels decreased significantly over the perioperative period and inversely correlated with Troponin T changes.
Why the study?
Circulating ketone bodies are elevated in cardiovascular disease, but whether this pattern applies to patients undergoing cardiac surgery involving cardiopulmonary bypass was unknown.
How do circulating ketone body levels change perioperatively and correlate with myocardial injury in patients undergoing cardiac surgery on cardiopulmonary bypass?
Observational (n=192)
How do circulating ketone body levels change perioperatively and correlate with myocardial injury in patients undergoing cardiac surgery on cardiopulmonary bypass?
Circulating ketone body levels decrease during cardiac surgery on cardiopulmonary bypass, and this decrease inversely correlates with the degree of myocardial injury as measured by Troponin T.
Answers are grounded in this paper and cite their sources.
Ketone trends may aid risk stratification after cardiac surgery; hypothesis-generating for metabolic interventions.
Ketone bodies (KBs) are energy-efficient substrates utilized by the heart depending on its metabolic demand and substrate availability. Levels of circulating KBs have been shown to be elevated in acute and chronic cardiovascular disease and are associated with severity of disease in patients with heart failure and functional outcome after myocardial infarction. To investigate whether this pattern similarly applies to patients undergoing cardiac surgery involving cardiopulmonary bypass (CPB), we analysed prospectively collected pre- and postoperative blood samples from 192 cardiac surgery patients and compared levels and perioperative changes in total KBs with Troponin T as a marker of myocardial cell injury. We explored the association of patient characteristics and comorbidities for each of the two biomarkers separately and comparatively. Median levels of KBs decreased significantly over the perioperative period and inversely correlated with changes observed for Troponin T. Associations of patient characteristics with ketone body perioperative course showed notable differences compared to Troponin T, possibly highlighting factors acting as a "driver" for the change in the respective biomarker. We found an inverse correlation between perioperative change in ketone body levels and changes in troponin, indicating a marked decrease in ketone body concentrations in patients exhibiting greater myocardial cell injury. Further investigations aimed at better understanding the role of KBs on perioperative changes are warranted.
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Levis et al. (2024) conducted an observational in Cardiac surgery involving cardiopulmonary bypass (n=192). Cardiac surgery involving cardiopulmonary bypass was evaluated on Perioperative changes in total ketone bodies compared with Troponin T. In patients undergoing cardiac surgery on cardiopulmonary bypass, circulating ketone body levels decreased significantly over the perioperative period and inversely correlated with Troponin T changes.
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