Heart failure & cardiomyopathies
Circulating 3-Hydroxy Butyrate Predicts Mortality in Patients with Chronic Heart Failure with Reduced Ejection Fraction
Authors' conclusion
In patients with HFrEF, circulating 3-OHB was a strong predictor of all-cause mortality independently of NT-proBNP. Circulating FFAs were the best predictor of 3-OHB levels.
Study context
- Population
- Patients with chronic heart failure with reduced ejection fraction (HFrEF)
- Participants
- 218 patients
- Exposure
- 3-OHB above vs below median
- Outcome
- All-cause mortality
- Follow-up
- Median 7.3 (IQR 6.3-8.4) years
Methodological detailsPlasma 3-OHB measured by high-performance liquid chromatography tandem mass spectrometry, Mortality from medical records linked to the national Central Person Registry
- Plasma 3-OHB measured by high-performance liquid chromatography tandem mass spectrometry
- Mortality from medical records linked to the national Central Person Registry
Main finding
As reported in the abstract
median follow-up 7.3 years
Hazard ratio (95% CI)P value
3-OHB above medianvs 3-OHB low levels
2.1(1.3–3.5)
P = 0.0033-OHBmultivariate analysis, independent of known chronic HF risk factors
1.004(1.001–1.007)
P = 0.02NT-proBNPmultivariate analysis
1.0005(1.000–1.001)
P = 0.02- Hazard of death per 100 μmol increase in plasma 3-OHB
- increased by 49%
Observational data: associations, not effects.
Further findings
Predictors of 3-OHB levels (univariate analysis)
| β (95% CI) | P value | |
|---|---|---|
| FFAs | 238 (185–292) | P < 0.0001 |
| Age | 2.43 (1.14–3.72) | P < 0.0001 |
| Plasma insulin | −0.28 (−0.54-(−0.02)) | P = 0.036 |
| BMI | −3.15 (−5.26-(−0.05)) | P = 0.046 |
| Diabetes | 44.49 (14.84–74.14) | P = 0.003 |
| Glycosylated haemoglobin | 1.92 (0.24–3.59) | P = 0.025 |
| NYHA class | 26.86 (5.99–47.72) | P = 0.012 |
| NT-proBNP | 0.03 (0.01–0.04) | P = 0.001 |
| Outcome | β (95% CI) | P value |
|---|---|---|
| Predictors of 3-OHB levels (multivariate analysis)Only FFAs predicted 3-OHB levels | 216 (165–268) | P > 0.001 |
Plasma 3-OHB levels
- Large variations in 3-OHB levels between patients: median 59 μM, range 14-694 μM
Original publication
Circulating 3-Hydroxy Butyrate Predicts Mortality in Patients with Chronic Heart Failure with Reduced Ejection Fraction. ESC Heart Fail. Published 9 January 2024. doi:10.
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