Acute effects of β-hydroxybutyrate on left ventricular function in young, healthy adults.
Acute effects of β-hydroxybutyrate on left ventricular function in young, healthy adults.
复制标题
β-羟基丁酸对年轻健康成年人左心室功能的急性影响。
DOI：
10.1152/japplphysiol.00630.2023
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Nelson,MichaelD
中科院分区：
文献类型：
--
作者：
Oneglia,AndrewP;Young,BenjaminE;Cipher,DaishaJ;Zaha,Vlad;Nelson,MichaelD
在心力衰竭患者给予外源性酮后心输出量显著增加的报道之后，对酮作为心脏“超级燃料”的兴趣显著增加。然而，心输出量的增加与心脏收缩力的变化相关的程度，以及取决于心力衰竭的存在，仍然不完全清楚。因此，我们在年轻健康志愿者中进行了一项口服酮酯的随机、双盲、安慰剂对照研究。基线心脏磁共振成像进行，并重复每15分钟后，酮和安慰剂摄入60分钟，以评估左心室功能的变化。正如预期的那样，摄入酮后循环β-羟基丁酸迅速增加，但安慰剂组没有变化（相互作用：P< 0.001）。与既往研究一致，酮摄入导致60分钟后心输出量平均增加1 L/min，而安慰剂组未发生（相互作用：P= 0.026）。心输出量增加主要是由摄入酮后心率增加（相互作用：P= 0.018）驱动的，每搏输出量仅适度增加（相互作用：P= 0.037）。左心室应变和扭转力学的变化有限。综上所述，循环β-羟基丁酸酯急性升高后心输出量的增加主要是由心脏变时性的变化驱动的，而变力性的贡献最小。新&值得注意的是在这项对年轻健康志愿者口服酮酯的随机、双盲、安慰剂对照研究中，我们发现心输出量显著增加（101 L/min），主要是由变时性的变化驱动的。心脏磁共振成像数据支持变力作用的有限性。
Interest in ketones as a cardiac “super fuel” has grown significantly following reports of a marked increase in cardiac output after exogenous ketone administration in heart failure. However, the extent to which this increase in cardiac output is related to changes in cardiac contractility, and dependent on the presence of heart failure, remains incompletely understood. Therefore, we performed a randomized, double-blind, placebo-controlled study of oral ketone ester in young healthy volunteers. Baseline cardiac magnetic resonance imaging was performed and repeated every 15 min for 60 min after ketone and placebo ingestion to assess changes in left ventricular function. As expected, circulating β-hydroxybutyrate increased rapidly after ketone ingestion, but did not change with placebo (interaction:P< 0.001). Consistent with prior investigations, ketone ingestion resulted in an average 1 L/min increase in cardiac output after 60 min that did not occur with placebo (interaction:P= 0.026). This increase in cardiac output was primarily driven by an increase in heart rate after ketone ingestion (interaction:P= 0.018), with only a modest increase in stroke volume (interaction:P= 0.037). Changes in left ventricular strain and twist mechanics were limited. Taken together, the increase in cardiac output following an acute elevation in circulating β-hydroxybutyrate is primarily driven by changes in cardiac chronotropy, with minimal inotropic contribution.NEW & NOTEWORTHYIn this randomized, double-blind, placebo-controlled study of oral ketone ester in young healthy volunteers, we show a marked increase in cardiac output (∼1 L/min), driven primarily by changes in chronotropy. The cardiac magnetic resonance imaging data support the limited role for inotropy.