Blood ketone bodies in congestive heart failure
Objectives. The present study was designed to assess whether blood ketone bodies are elevated in congestive heart failure (CHF) and whether ketonemia is related to the hemodynamic and neurohumoral abnormalities of CHF. Background. In CHF, consumption of the body's fat stores may become abnormal...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1996-09, Vol.28 (3), p.665-672 |
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| creator | Lommi, Jyri Kupari, Markku Koskinen, Pekka Näveri, Hannu Leinonen, Hannu Pulkki, Kari Härkönen, Matti |
| description | Objectives. The present study was designed to assess whether blood ketone bodies are elevated in congestive heart failure (CHF) and whether ketonemia is related to the hemodynamic and neurohumoral abnormalities of CHF.
Background. In CHF, consumption of the body's fat stores may become abnormally high, contributing to the development of cardiac cachexia. Increased mobilization of free fatty acids could, in theory, augment ketogenesis, but whether patients with CHF are prone to ketosis remains unknown.
Methods. Forty-five patients with chronic CHF (mean age [±SD] 57 ± 13 years) and 14 control subjects free of CHF (mean age 53 ± 13 years) underwent invasive and noninvasive cardiac studies and determination of blood ketone bodies (acetoacetate plus beta-hydroxybutyrate), circulating free fatty acids, glucose, lactate, insulin, glucagon, growth hormone, cortisol, norepinephrine, N-terminal proatrial natriuretic peptide, tumor necrosis factor-alpha and interleukin-6 after an overnight fast.
Results. Patients with CHF had elevated blood ketone bodies (median 267 μmol/liter, range 44 to 952) compared with control subjects (median 150 μmol/liter, range 31 to 299, p < 0.05). In the total study group, blood ketone bodies were related to pulmonary artery wedge pressure (rs = 0.45, p < 0.001), left ventricular ejection fraction (rs = −0.37, p < 0.01), right atrial pressure (rs = 0.36, p < 0.01) and circulating concentrations of free fatty acids (rs = 0.52, p < 0.001), glucose (rs = −0.39, p < 0.01), norepinephrine (rs = 0.45, p < 0.001), growth hormone (rs = 0.30, p < 0.05) and interleukin-6 (rs = 0.27, p < 0.05). In multivariate analysis, left ventricular ejection fraction, serum free fatty acids and serum glucose were independent predictors of ketonemia.
Conclusions. Blood ketone bodies are elevated in CHF in proportion to the severity of cardiac dysfunction and neurohormonal activation. This may be at least partly attributable to increased free fatty acid mobilization in response to augmented neurohormonal stimulation. Additional studies are needed to identify the detailed mechanisms and clinical implications of CHF ketosis. |
| doi_str_mv | 10.1016/0735-1097(96)00214-8 |
| format | Article |
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Background. In CHF, consumption of the body's fat stores may become abnormally high, contributing to the development of cardiac cachexia. Increased mobilization of free fatty acids could, in theory, augment ketogenesis, but whether patients with CHF are prone to ketosis remains unknown.
Methods. Forty-five patients with chronic CHF (mean age [±SD] 57 ± 13 years) and 14 control subjects free of CHF (mean age 53 ± 13 years) underwent invasive and noninvasive cardiac studies and determination of blood ketone bodies (acetoacetate plus beta-hydroxybutyrate), circulating free fatty acids, glucose, lactate, insulin, glucagon, growth hormone, cortisol, norepinephrine, N-terminal proatrial natriuretic peptide, tumor necrosis factor-alpha and interleukin-6 after an overnight fast.
Results. Patients with CHF had elevated blood ketone bodies (median 267 μmol/liter, range 44 to 952) compared with control subjects (median 150 μmol/liter, range 31 to 299, p < 0.05). In the total study group, blood ketone bodies were related to pulmonary artery wedge pressure (rs = 0.45, p < 0.001), left ventricular ejection fraction (rs = −0.37, p < 0.01), right atrial pressure (rs = 0.36, p < 0.01) and circulating concentrations of free fatty acids (rs = 0.52, p < 0.001), glucose (rs = −0.39, p < 0.01), norepinephrine (rs = 0.45, p < 0.001), growth hormone (rs = 0.30, p < 0.05) and interleukin-6 (rs = 0.27, p < 0.05). In multivariate analysis, left ventricular ejection fraction, serum free fatty acids and serum glucose were independent predictors of ketonemia.
Conclusions. Blood ketone bodies are elevated in CHF in proportion to the severity of cardiac dysfunction and neurohormonal activation. This may be at least partly attributable to increased free fatty acid mobilization in response to augmented neurohormonal stimulation. Additional studies are needed to identify the detailed mechanisms and clinical implications of CHF ketosis.]]></description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(96)00214-8</identifier><identifier>PMID: 8772754</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Calorimetry, Indirect ; Cardiology. Vascular system ; Cytokines - blood ; Fatty Acids, Nonesterified - blood ; Female ; Heart ; Heart Failure - blood ; Heart Failure - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Hemodynamics ; Hormones - blood ; Humans ; Ketone Bodies - blood ; Male ; Medical sciences ; Middle Aged</subject><ispartof>Journal of the American College of Cardiology, 1996-09, Vol.28 (3), p.665-672</ispartof><rights>1996</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-1aeeb0dfe4b6a101aebdbcc9b86fa32cc3cd5913407af7c35a14a6f12976c12f3</citedby><cites>FETCH-LOGICAL-c398t-1aeeb0dfe4b6a101aebdbcc9b86fa32cc3cd5913407af7c35a14a6f12976c12f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0735-1097(96)00214-8$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3203976$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8772754$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lommi, Jyri</creatorcontrib><creatorcontrib>Kupari, Markku</creatorcontrib><creatorcontrib>Koskinen, Pekka</creatorcontrib><creatorcontrib>Näveri, Hannu</creatorcontrib><creatorcontrib>Leinonen, Hannu</creatorcontrib><creatorcontrib>Pulkki, Kari</creatorcontrib><creatorcontrib>Härkönen, Matti</creatorcontrib><title>Blood ketone bodies in congestive heart failure</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description><![CDATA[Objectives. The present study was designed to assess whether blood ketone bodies are elevated in congestive heart failure (CHF) and whether ketonemia is related to the hemodynamic and neurohumoral abnormalities of CHF.
Background. In CHF, consumption of the body's fat stores may become abnormally high, contributing to the development of cardiac cachexia. Increased mobilization of free fatty acids could, in theory, augment ketogenesis, but whether patients with CHF are prone to ketosis remains unknown.
Methods. Forty-five patients with chronic CHF (mean age [±SD] 57 ± 13 years) and 14 control subjects free of CHF (mean age 53 ± 13 years) underwent invasive and noninvasive cardiac studies and determination of blood ketone bodies (acetoacetate plus beta-hydroxybutyrate), circulating free fatty acids, glucose, lactate, insulin, glucagon, growth hormone, cortisol, norepinephrine, N-terminal proatrial natriuretic peptide, tumor necrosis factor-alpha and interleukin-6 after an overnight fast.
Results. Patients with CHF had elevated blood ketone bodies (median 267 μmol/liter, range 44 to 952) compared with control subjects (median 150 μmol/liter, range 31 to 299, p < 0.05). In the total study group, blood ketone bodies were related to pulmonary artery wedge pressure (rs = 0.45, p < 0.001), left ventricular ejection fraction (rs = −0.37, p < 0.01), right atrial pressure (rs = 0.36, p < 0.01) and circulating concentrations of free fatty acids (rs = 0.52, p < 0.001), glucose (rs = −0.39, p < 0.01), norepinephrine (rs = 0.45, p < 0.001), growth hormone (rs = 0.30, p < 0.05) and interleukin-6 (rs = 0.27, p < 0.05). In multivariate analysis, left ventricular ejection fraction, serum free fatty acids and serum glucose were independent predictors of ketonemia.
Conclusions. Blood ketone bodies are elevated in CHF in proportion to the severity of cardiac dysfunction and neurohormonal activation. This may be at least partly attributable to increased free fatty acid mobilization in response to augmented neurohormonal stimulation. Additional studies are needed to identify the detailed mechanisms and clinical implications of CHF ketosis.]]></description><subject>Biological and medical sciences</subject><subject>Calorimetry, Indirect</subject><subject>Cardiology. Vascular system</subject><subject>Cytokines - blood</subject><subject>Fatty Acids, Nonesterified - blood</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - physiopathology</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Hemodynamics</subject><subject>Hormones - blood</subject><subject>Humans</subject><subject>Ketone Bodies - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMo67r6DxR6ENFD3aRpmuQi6OIXLHjRc0jTiUa7jSbtgv_eLFv26GkY5nmHlwehU4KvCSbVHHPKcoIlv5TVFcYFKXOxh6aEMZFTJvk-mu6QQ3QU4yfGuBJETtBEcF5wVk7R_K71vsm-oPcdZLVvHMTMdZnx3TvE3q0h-wAd-sxq1w4BjtGB1W2Ek3HO0NvD_eviKV--PD4vbpe5oVL0OdEANW4slHWlU1sNdVMbI2tRWU0LY6hpmCS0xFxbbijTpNSVJYXklSGFpTN0sf37HfzPkJqolYsG2lZ34IeouCi4JAVLYLkFTfAxBrDqO7iVDr-KYLXxpDYS1EaCkmnZeFIixc7G_0O9gmYXGsWk-_l419Ho1gbdGRd3GC0wTVUTdrPFILlYOwgqGgedgcYFML1qvPu_xx910YOG</recordid><startdate>19960901</startdate><enddate>19960901</enddate><creator>Lommi, Jyri</creator><creator>Kupari, Markku</creator><creator>Koskinen, Pekka</creator><creator>Näveri, Hannu</creator><creator>Leinonen, Hannu</creator><creator>Pulkki, Kari</creator><creator>Härkönen, Matti</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19960901</creationdate><title>Blood ketone bodies in congestive heart failure</title><author>Lommi, Jyri ; Kupari, Markku ; Koskinen, Pekka ; Näveri, Hannu ; Leinonen, Hannu ; Pulkki, Kari ; Härkönen, Matti</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-1aeeb0dfe4b6a101aebdbcc9b86fa32cc3cd5913407af7c35a14a6f12976c12f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Biological and medical sciences</topic><topic>Calorimetry, Indirect</topic><topic>Cardiology. Vascular system</topic><topic>Cytokines - blood</topic><topic>Fatty Acids, Nonesterified - blood</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - physiopathology</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Hemodynamics</topic><topic>Hormones - blood</topic><topic>Humans</topic><topic>Ketone Bodies - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lommi, Jyri</creatorcontrib><creatorcontrib>Kupari, Markku</creatorcontrib><creatorcontrib>Koskinen, Pekka</creatorcontrib><creatorcontrib>Näveri, Hannu</creatorcontrib><creatorcontrib>Leinonen, Hannu</creatorcontrib><creatorcontrib>Pulkki, Kari</creatorcontrib><creatorcontrib>Härkönen, Matti</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lommi, Jyri</au><au>Kupari, Markku</au><au>Koskinen, Pekka</au><au>Näveri, Hannu</au><au>Leinonen, Hannu</au><au>Pulkki, Kari</au><au>Härkönen, Matti</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood ketone bodies in congestive heart failure</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1996-09-01</date><risdate>1996</risdate><volume>28</volume><issue>3</issue><spage>665</spage><epage>672</epage><pages>665-672</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract><![CDATA[Objectives. The present study was designed to assess whether blood ketone bodies are elevated in congestive heart failure (CHF) and whether ketonemia is related to the hemodynamic and neurohumoral abnormalities of CHF.
Background. In CHF, consumption of the body's fat stores may become abnormally high, contributing to the development of cardiac cachexia. Increased mobilization of free fatty acids could, in theory, augment ketogenesis, but whether patients with CHF are prone to ketosis remains unknown.
Methods. Forty-five patients with chronic CHF (mean age [±SD] 57 ± 13 years) and 14 control subjects free of CHF (mean age 53 ± 13 years) underwent invasive and noninvasive cardiac studies and determination of blood ketone bodies (acetoacetate plus beta-hydroxybutyrate), circulating free fatty acids, glucose, lactate, insulin, glucagon, growth hormone, cortisol, norepinephrine, N-terminal proatrial natriuretic peptide, tumor necrosis factor-alpha and interleukin-6 after an overnight fast.
Results. Patients with CHF had elevated blood ketone bodies (median 267 μmol/liter, range 44 to 952) compared with control subjects (median 150 μmol/liter, range 31 to 299, p < 0.05). In the total study group, blood ketone bodies were related to pulmonary artery wedge pressure (rs = 0.45, p < 0.001), left ventricular ejection fraction (rs = −0.37, p < 0.01), right atrial pressure (rs = 0.36, p < 0.01) and circulating concentrations of free fatty acids (rs = 0.52, p < 0.001), glucose (rs = −0.39, p < 0.01), norepinephrine (rs = 0.45, p < 0.001), growth hormone (rs = 0.30, p < 0.05) and interleukin-6 (rs = 0.27, p < 0.05). In multivariate analysis, left ventricular ejection fraction, serum free fatty acids and serum glucose were independent predictors of ketonemia.
Conclusions. Blood ketone bodies are elevated in CHF in proportion to the severity of cardiac dysfunction and neurohormonal activation. This may be at least partly attributable to increased free fatty acid mobilization in response to augmented neurohormonal stimulation. Additional studies are needed to identify the detailed mechanisms and clinical implications of CHF ketosis.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8772754</pmid><doi>10.1016/0735-1097(96)00214-8</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Calorimetry, Indirect Cardiology. Vascular system Cytokines - blood Fatty Acids, Nonesterified - blood Female Heart Heart Failure - blood Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Hemodynamics Hormones - blood Humans Ketone Bodies - blood Male Medical sciences Middle Aged |
| title | Blood ketone bodies in congestive heart failure |
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