Heart failure & cardiomyopathies
Circulating Beta-Hydroxybutyrate Levels in Advanced Heart Failure with Reduced Ejection Fraction: Determinants and Prognostic Impact
Main finding · Composite events (512: 324 deaths, 81 LV assist device implantations, 107 urgent cardiac transplantations)Result — go to the resultHazard ratio 1.39 95% CI 1.13–1.72Authors' conclusion
In patients with advanced HFrEF, increased plasma β-OHB correlate with FFA levels, worse right ventricular function, greater neurohormonal activation and other markers of HF severity. The association between plasma β-OHB and adverse outcomes is eliminated after accounting for FFA levels, suggesting that increased β-OHB is a consequence reflecting heightened lipolytic state, rather than a cause of worsening HF.
Study context
- Population
- Patients with advanced HF and reduced ejection fraction (HFrEF) (age 57 ± 11 years, 83% male, 45% diabetic, 60% NYHA class III)right heart catheterization n = 383
- Participants
- 867 patients
- Exposure
- β-OHB tertiles
- Outcome
- Composite of:
- Death
- LV assist device implantation
- Urgent cardiac transplantation
- Follow-up
- Median 1126 (IQR 410-1781) days
Main finding
As reported in the abstract
Composite events (512:
- 324 deaths
- 81 LV assist device implantations
- 107 urgent cardiac transplantations)
Hazard ratio
1.39
95% CI 1.13–1.72
P = 0.002
T3vs T1
HR 1.39 (95% CI 1.13–1.72); P = 0.002
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Composite events by FFA tertileFFA tertiles, univariable Cox regression | 1.39 (1.09–1.79) | P = 0.008 | |
| 0.512Hazard ratio (log scale) |
Circulating β-OHB level
- Median β-OHB 64 (IQR 33-161) μmol/L (normal 0-74 μmol/L)
Correlates of β-OHB
- β-OHB correlated with higher FFA, higher natriuretic peptides, worse pulmonary haemodynamics and lower insulin/glucagon ratio
Original publication
Circulating Beta-Hydroxybutyrate Levels in Advanced Heart Failure with Reduced Ejection Fraction: Determinants and Prognostic Impact. Eur J Heart Fail. Published 10 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →