ArticleCirculation. Heart failure2021
Ketone Ester Treatment Improves Cardiac Function and Reduces Pathologic Remodeling in Preclinical Models of Heart Failure.
Article in Circulation. Heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05924802 (Physiological Effects of Dietary Supplement Ketone Ester on the Heart), which is not on this map. Cited by 99 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Physiological Effects of Dietary Supplement Ketone Ester on the Heart
Who cites it
99 citing papers in PubMed, 142 citations in OpenAlex.
- 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
- A ketogenic-promoting beverage acutely elevates cardiac function and myocardial blood flow compared to placebo in adults: A cardiac MRI investigation.Physiological reports · 2025Trial
- 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
- Cardiovascular Effects of Oral Ketone Ester Treatment in Patients With Heart Failure With Reduced Ejection Fraction: A Randomized, Controlled, Double-Blind Trial.Circulation · 2024Trial
- Hemodynamic Effects of Ketone Bodies in Patients With Pulmonary Hypertension.Journal of the American Heart Association · 2023Trial
- Empagliflozin in acute myocardial infarction: the EMMY trial.European heart journal · 2022 · on this mapTrial
- Continuously elevated plasma ketone bodies are linked to adverse outcomes in patients with heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Inflammatory and catabolic activity mediate the association of plasma β-hydroxybutyrate and mortality in heart failure.ESC heart failure · 2026Observational
- Causal link between circulating beta-hydroxybutyrate and myocardial infarction: Evidence from Mendelian randomization.Medicine · 2026Article
- Apabetalone Drives a Metabolic Shift Towards Ketogenesis and Reduces Liver Steatosis in Diet-Induced Obesity Mice.Biomedicines · 2026Article
- Effects of ketone bodies supplementation in patients with heart failure: A systematic review and meta-analysis.World journal of critical care medicine · 2026Article
- Ketogenic diet, cardiometabolic diseases and aging.Journal of geriatric cardiology : JGC · 2026Article
- Sodium-glucose Co-transporter 2 (SGLT2) inhibitor dapagliflozin acutely activates cardiomyocyte HIF-1α signaling via succinate, a signaling metabolite.Journal of pharmacological sciences · 2026Article
- Mitochondrial Resilience: Unraveling the Triadic Interplay of Phosphocreatine, Cyclophilin D, and STAT3 in Heart Failure.Journal of cardiovascular translational research · 2026Review
- Review
- Beyond glycemic control: SGLT2 inhibitors as time-sensitive organ-protective agents in acute injury-mechanistic insights and translational implications.Frontiers in pharmacology · 2026Review
- The multifaceted roles of ketones in physiology.Experimental physiology · 2026Review
- Metabolic regulation for the treatment of ischemic heart disease with stem cells and extracellular vesicles.NPJ cardiovascular health · 2025Review
- The crosstalk between immune activation and metabolism in heart failure. A scientific statement of the Heart Failure Association of the ESC.European journal of heart failure · 2025Review
- Left ventricular myocardial molecular profile of human diabetic ischaemic cardiomyopathy.EMBO molecular medicine · 2025Article
39 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundAccumulating evidence suggests that the failing heart reprograms fuel metabolism toward increased utilization of ketone bodies and that increasing cardiac ketone delivery ameliorates cardiac dysfunction. As an initial step toward development of ketone therapies, we investigated the effect of chronic oral ketone ester (KE) supplementation as a prevention or treatment strategy in rodent heart failure models.
methodsTwo independent rodent heart failure models were used for the studies: transverse aortic constriction/myocardial infarction (MI) in mice and post-MI remodeling in rats. Seventy-five mice underwent a prevention treatment strategy with a KE comprised of hexanoyl-hexyl-3-hydroxybutyrate KE (KE-1) diet, and 77 rats were treated in either a prevention or treatment regimen using a commercially available β-hydroxybutyrate-(R)-1,3-butanediol monoester (DeltaG; KE-2) diet.
resultsThe KE-1 diet in mice elevated β-hydroxybutyrate levels during nocturnal feeding, whereas the KE-2 diet in rats induced ketonemia throughout a 24-hour period. The KE-1 diet preventive strategy attenuated development of left ventricular dysfunction and remodeling post-transverse aortic constriction/MI (left ventricular ejection fraction±SD, 36±8 in vehicle versus 45±11 in KE-1;
conclusionsChronic oral supplementation with KE was effective in both prevention and treatment of heart failure in 2 preclinical animal models. In addition, our results indicate that treatment with KE reprogrammed the expression of genes involved in ketone body utilization and normalized myocardial ATP production following MI, consistent with provision of an auxiliary fuel. These findings provide rationale for the assessment of KEs as a treatment for patients with 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.