ArticleEuropean journal of clinical investigation2021
Association of beta-hydroxybutyrate with development of heart failure: Sex differences in a Dutch population cohort.
Article in European journal of clinical investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 45 citations in OpenAlex.
- Inflammatory and catabolic activity mediate the association of plasma β-hydroxybutyrate and mortality in heart failure.ESC heart failure · 2026Observational
- Emerging Roles for Metabolism in Myocardial Inflammation During Heart Failure.Immunological reviews · 2026Review
- Sex-Specific Determinants of the Ketone Body β-Hydroxybutyrate in the General Population.The Journal of clinical endocrinology and metabolism · 2026Article
- Circulating Ketone Bodies and Incident Cardiovascular Outcomes and Mortality: Insights From the UK Biobank.Journal of the American Heart Association · 2026Article
- Integrating ketone bodies in multi-marker risk prediction of incident heart failure in the multi-ethnic study of atherosclerosis.European journal of preventive cardiology · 2026Article
- Ketone bodies and incident heart failure: 20-year results from the prospective British Regional Heart Study.ESC heart failure · 2026Article
- Review
- The regulatory role of exercise in heart failure and myocardial energy metabolism: A review.Biomolecules & biomedicine · 2025Review
- Circulating FGF21 and Ketone Bodies Modify the Risk of MASLD and Mortality: Insights from the PREVEND Cohort Study.International journal of molecular sciences · 2025Article
- Plasma Beta-Hydroxybutyrate and All-Cause Mortality in Patients with Liver Cirrhosis.Biomedicines · 2025Article
- Characteristics of Cardiac Ketone Body Metabolism Throughout the Life Cycle.Cardiovascular therapeutics · 2025Review
- Exogenous Ketones in Cardiovascular Disease and Diabetes: From Bench to Bedside.Journal of clinical medicine · 2024Review
- Metabolic Signatures of Blood Pressure and Risk of Cardiovascular Diseases.Journal of the American Heart Association · 2024Article
- Towards Metabolomic-Based Precision Approaches for Classifying and Treating Heart Failure.JACC. Basic to translational science · 2024Review
- Circulating 3-hydroxy butyrate predicts mortality in patients with chronic heart failure with reduced ejection fraction.ESC heart failure · 2024Article
- Fasting Plasma Ketone Bodies Are Associated with NT-proBNP: A Potential Mechanism to Provide Fuel for the Failing Heart.Journal of clinical medicine · 2024Article
- A Set of Possible Markers for Monitoring Heart Failure and Cognitive Impairment Associated: A Review of Literature from the Past 5 Years.Biomolecules · 2024Review
- Circulating ketone bodies and mortality in heart failure: a community cohort study.Frontiers in cardiovascular medicine · 2024Article
- Elevated Plasma Levels of Ketone Bodies Are Associated With All-Cause Mortality and Incidence of Heart Failure in Older Adults: The CHS.Journal of the American Heart Association · 2023Article
- Mechanisms Linking Metabolic-Associated Fatty Liver Disease (MAFLD) to Cardiovascular Disease.Current hypertension reports · 2023Review
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundIn the failing heart, energy metabolism is shifted towards increased ketone body oxidation. Nevertheless, the association of beta-hydroxybutyrate (β-OHB) with development of heart failure (HF) remains unclear. We investigated the association between plasma β-OHB and the risk of HF in a prospective population-based cohort.
designPlasma β-OHB concentrations were measured in 6134 participants of the PREVEND study. Risk of incident HF with reduced (HFrEF) or preserved (HFpEF) ejection fraction was estimated using multivariable-adjusted Cox regression models.
resultsDuring median follow-up for 8.2 years, 227 subjects were diagnosed with HF (137 with HFrEF; 90 with HFpEF). Cox regression analyses revealed a significant association of higher β-OHB concentrations with incident HF (HR per 1 standard deviation increase, 1.40 (95% CI: 1.21-1.63; P < .001), which was largely attributable to HFrEF. In women, the hazard ratio (HR) for HFrEF per 1 standard deviation increase in β-OHB was 1.73 (95% confidence interval (CI): 1.17-2.56, P = .005) in age, BMI, type 2 diabetes, hypertension, myocardial infarction, smoking, alcohol consumption, total cholesterol, HDL-C, triglycerides, glucose, eGFR and UAE adjusted analysis. In men, in the same fully adjusted analysis, the HR was 1.14 (CI: 0.86-1.53, P = .36) (P < .01 for sex interaction). In N-terminal pro-brain natriuretic peptide (NT-proBNP)-stratified analysis, the age-adjusted association with HF was significant in women with higher NT-proBNP levels (P = .008).
conclusionsThis prospective study suggests that high plasma concentrations of β-OHB are associated with an increased risk of HFrEF, particularly in women. The mechanisms responsible for the sex differences of this association warrant further study.
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