Therapeutic Potential of Ketone Bodies for Patients With Cardiovascular Disease: JACC State-of-the-Art Review

Metabolic perturbations underlie a variety of cardiovascular disease states; yet, metabolic interventions to prevent or treat these disorders are sparse. Ketones carry a negative clinical stigma as they are involved in diabetic ketoacidosis. However, evidence from both experimental and clinical rese...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2021-04, Vol.77 (13), p.1660-1669
Main Authors: Yurista, Salva R, Chong, Cher-Rin, Badimon, Juan J, Kelly, Daniel P, de Boer, Rudolf A, Westenbrink, B Daan
Format: Article
Language:English
Subjects:
Animals
Dietary Supplements
Heart Diseases - therapy
Humans
Ketone Bodies - pharmacology
Ketone Bodies - therapeutic use
Ketones - metabolism
Myocardium - metabolism
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Summary:Metabolic perturbations underlie a variety of cardiovascular disease states; yet, metabolic interventions to prevent or treat these disorders are sparse. Ketones carry a negative clinical stigma as they are involved in diabetic ketoacidosis. However, evidence from both experimental and clinical research has uncovered a protective role for ketones in cardiovascular disease. Although ketones may provide supplemental fuel for the energy-starved heart, their cardiovascular effects appear to extend far beyond cardiac energetics. Indeed, ketone bodies have been shown to influence a variety of cellular processes including gene transcription, inflammation and oxidative stress, endothelial function, cardiac remodeling, and cardiovascular risk factors. This paper reviews the bioenergetic and pleiotropic effects of ketone bodies that could potentially contribute to its cardiovascular benefits based on evidence from animal and human studies.
ISSN:1558-3597
DOI:10.1016/j.jacc.2020.12.065