ArticleJCI insight2019
The failing heart utilizes 3-hydroxybutyrate as a metabolic stress defense.
Article in JCI insight, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 228 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
228 citing papers in PubMed, 357 citations in OpenAlex.
- Retatrutide and lipid and metabolite profiles in participants with obesity with or without type 2 diabetes.The Journal of clinical endocrinology and metabolism · 2026Trial
- Determinants of Adherence to a Ketogenic Diet in Patients with Heart Failure with Reduced Ejection Fraction.Nutrients · 2026Trial
- Exploratory functional and quality of life outcomes with daily consumption of the ketone ester bis-octanoyl (R)-1,3-butanediol in healthy older adults: a randomized, parallel arm, double-blind, placebo-controlled study.The Journal of frailty & aging · 2025Trial
- Fasting substrates predict chronic kidney disease progression in CREDENCE trial patients with type 2 diabetes.JCI insight · 2024 · on this mapTrial
- Daily consumption of ketone ester, bis-octanoyl (R)-1,3-butanediol, is safe and tolerable in healthy older adults in a randomized, parallel arm, double-blind, placebo-controlled, pilot study.The journal of nutrition, health & aging · 2024Trial
- Ketone body levels and its associations with cardiac markers following an acute myocardial infarction: a post hoc analysis of the EMMY trial.Cardiovascular diabetology · 2024Trial
- Weight loss-independent changes in human growth hormone during water-only fasting: a secondary evaluation of a randomized controlled trial.Frontiers in endocrinology · 2024Trial
- Acute effects of β-hydroxybutyrate on left ventricular function in young, healthy adults.Journal of applied physiology (Bethesda, Md. : 1985) · 2023Trial
- Stimulation of the Hydroxycarboxylic Acid Receptor 2 With the Ketone Body 3-Hydroxybutyrate and Niacin in Patients With Chronic Heart Failure: Hemodynamic and Metabolic Effects.Journal of the American Heart Association · 2023Trial
- Empagliflozin in acute myocardial infarction: the EMMY trial.European heart journal · 2022 · on this mapTrial
- Pharmacometabolomic profiles in type 2 diabetic subjects treated with liraglutide or glimepiride.Cardiovascular diabetology · 2021 · on this mapTrial
- A prospective randomized study comparing effects of empagliflozin to sitagliptin on cardiac fat accumulation, cardiac function, and cardiac metabolism in patients with early-stage type 2 diabetes: the ASSET study.Cardiovascular diabetology · 2021Trial
- Impact of pre-arrest glycemic state induced by prolonged fasting on defibrillation requirements: a prospective porcine model of ventricular fibrillation cardiac arrest.Resuscitation plus · 2026Article
- Redox coupling of lactate and β-hydroxybutyrate: An inter-organ circuit linking metabolic flexibility, mitochondrial adaptation, and disease.Redox biology · 2026Review
- Serum Metabolomic Profiling for Acute Myocardial Infarction Based on Nuclear Magnetic Resonance Spectroscopy.NMR in biomedicine · 2026Article
- Inflammatory and catabolic activity mediate the association of plasma β-hydroxybutyrate and mortality in heart failure.ESC heart failure · 2026Observational
- Article
- HFpEF and MASLD: converging mechanisms and clinical implications.Nature reviews. Cardiology · 2026Review
- Causal link between circulating beta-hydroxybutyrate and myocardial infarction: Evidence from Mendelian randomization.Medicine · 2026Article
- Sarcopenia and Its Associated Metabolic Profile Predict Incident Heart Failure: A Prospective Cohort Study of 267 335 Adults in the UK Biobank.Journal of the American Heart Association · 2026Article
168 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
Abstract
Evidence has emerged that the failing heart increases utilization of ketone bodies. We sought to determine whether this fuel shift is adaptive. Mice rendered incapable of oxidizing the ketone body 3-hydroxybutyrate (3OHB) in the heart exhibited worsened heart failure in response to fasting or a pressure overload/ischemic insult compared with WT controls. Increased delivery of 3OHB ameliorated pathologic cardiac remodeling and dysfunction in mice and in a canine pacing model of progressive heart failure. 3OHB was shown to enhance bioenergetic thermodynamics of isolated mitochondria in the context of limiting levels of fatty acids. These results indicate that the heart utilizes 3OHB as a metabolic stress defense and suggest that strategies aimed at increasing ketone delivery to the heart could prove useful in the treatment of heart failure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.