文献类型：期刊文献

英文题名：Potential causes and significance of elevated blood ketone levels in patients with heart failure with preserved ejection fraction

作者：Lu, Weijie[1];Liu, Ai[1];Liu, Mengyang[1];Hu, Yujie[2];Yang, Kang[1];Deng, Yaoting[1];Li, Qianrong[1];Wang, Bowen[1];Li, Yanling[1];Jiang, Bing[1];Wang, Gang[2];Wang, Xuehan[2];Jiang, HuGang[1];Xie, Ping[3]

第一作者：Lu, Weijie

通信作者：Xie, P[1]

机构：[1]Gansu Univ Tradit Chinese Med, Dept Integrat Chinese & Western Med, Lanzhou, Peoples R China;[2]Lanzhou Univ, Dept Clin Med, Lanzhou, Peoples R China;[3]Gansu Prov Peoples Hosp, Dept Cardiol, Lanzhou, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Peoples Hosp, Dept Cardiol, Lanzhou, Peoples R China.

年份：2026

卷号：12

外文期刊名：FRONTIERS IN NUTRITION

收录：;Scopus(收录号：2-s2.0-105028437777);WOS:【SCI-EXPANDED(收录号:WOS:001668572200001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. This study was supported by Quality Standard of Xanthoceras sorbifolia Bunge in Gansu Province and Prospective Multicenter Randomized Controlled Clinical Study on Treatment of Metabolic Syndrome (GZKZ-2021-7), Gansu Provincial People's Hospital Excellent Doctoral Training Program (22GSSYD-14), National Natural Science Foundation of China (No. 8246020036), the Major Collaborative Project of the Gansu Provincial Department of Science and Technology (No. 24JRRA886), the Graduate Innovation and Entrepreneurship Program of Gansu University of Chinese Medicine (No. 2025CXZX-917), and the Internal Research Fund of Gansu Provincial People's Hospital (No. 24GSSYE-15), for which the authors express their sincere appreciation.

语种：英文

外文关键词：assessment value; blood ketones; clinical research; diagnostic value; heart failure with preserved ejection fraction

摘要：Background The diagnosis of heart failure with preserved ejection fraction (HFpEF) remains challenging. Given the critical role of metabolic disturbance and energy expenditure in HFpEF pathophysiology, we investigated the clinical significance and diagnostic value of blood ketone bodies in these patients.Methods This case-control study enrolled 160 participants, comprising 80 HFpEF patients and 80 matched healthy controls. Baseline characteristics, levels of blood ketones (acetoacetate, beta-hydroxybutyrate, acetone), and NT-proBNP were compared. Multivariate linear regression and correlation analyses were employed to assess the associations between ketone levels, clinical parameters, and NT-proBNP. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis.Results Compared to controls, HFpEF patients showed significant differences in age, heart rate, BMI, and blood pressure. Multivariate regression revealed a significant linear association between BMI, systolic blood pressure, and acetoacetate levels in the HFpEF group. A weak inverse correlation was found between acetoacetate and NT-proBNP levels. However, no correlation was observed between ketone levels and NYHA functional class. ROC analysis demonstrated that the combination of acetoacetate and NT-proBNP yielded the highest diagnostic efficacy (AUC = 0.9117), superior to NT-proBNP alone (AUC = 0.8328) or any ketone body alone.Conclusion Unlike nutritional ketosis, elevated blood ketone levels in patients with HFpEF likely reflect impaired metabolic efficiency rather than a marker of cardiac function. Nevertheless, this phenomenon has diagnostic significance: combining acetoacetate with NT-proBNP can markedly improve diagnostic performance.