Two of the researchers behind the study on ketone bodies and heart failure - from left Henrik Wiggers and Roni Nielsen, Aarhus University Hospital (photo: Tonny Foghmar).

New research shows that ketone bodies have a marked effect in patients with heart failure.

Ketones are the body’s own super fuel, released during stress and prolonged fasting. Ketones can be bought as a dietary supplement to increase metabolism and provide extra energy.

Doctors and researchers at Aarhus University Hospital and Aarhus University have just published a study in a leading American scientific journal, investigating the effect of ketone bodies in patients with heart failure.

The results show that infusion of ketones directly into the patients blood stream, increased the cardiac pump function by 8%. At the same time, the amount of output from the heart increased by two litres – equivalent to an increase of 40%.

- This is a unique and fantastic result. This can be the start of a new treatment for patients with heart failure, says Henrik Wiggers, Consultant at Department of Cardiology, Aarhus University Hospital.

The study has been done in collaboration with colleagues at Department of Endocrinology and Internal Medicine, Department of Nuclear Medicine and PET Centre. The colleague of Henrik Wiggers, Roni Nielsen, Postdoc. at Department of Cardiology is the first author of the study.

- The results are very promising and there may be a huge potential in this type of treatment.

Patients with heart failure have a reduced pump function and to this patient group the results are particularly encouraging. The researchers do not yet know exactly how ketones affect the heart. It is, however, a fact that the heart pumps more effectively if the body is infused with ketones.

Dietary supplement as medicine

This study is the first to investigate the effect of ketone bodies on patients with heart disease, but more studies are needed to support the results. The researchers from Aarhus University Hospital have already received funding to complete new clinical studies on the use of ketoness. They apply for further funding because they have many ideas to future research projects with ketones in heart failure patients.

- I would like to stress that there is a need for further studies before ketones c recommended in patients with heart failure, says Henrik Wiggers.

- But if our future studies show positive results, we are one step closer to developing a dietary supplement with ketone bodies to patients with heart failure.

In future studies the researchers are planning both to inject ketones, use them as a supplement in drinks and in gastrointestinal tube feeding. The treatment will be inexpensive since the ketone bodies are registered as a dietary supplement and there is no patent. This means that it does not have to go through a long approval process.

Inspiration from diabetes medicine

The idea to do a study on ketones and patients with heart failure originates from diabetes. In recent years, the so-called SGLT2-inhibitors used in medical treatment of persons with type 2 diabetes have been investigated.

This medicine has proven beneficial in patients with heart failure and one of the reasons may be that SGLT2-inhibitors activate the body’s own ketones.


Behind the research result:

Type of study: Clinical randomised trial.

Collaborators: Researchers for Department of Cardiology, Department of Endocrinology and Internal Medicine, Department of Nuclear Medicine and PET Centre at Aarhus University Hospital and Department of Nuclear Medicine, Uppsala University, Sweden.

External financing: Lundbeck Foundation.

Publishing: Peer-reviewed article in Circulation, published by the American Heart Association.

Conflicts of interest: None.

Read the scientific article:

Nielsen RMøller NGormsen LCTolbod LPHansson NH4, Sorensen JHarms HJFrøkiær JEiskjaer HJespersen NRMellemkjaer SLassen TRPryds KBøtker HEWiggers H.
Cardiovascular Effects of Treatment with the Ketone Body 3-Hydroxybutyrate in Chronic Heart Failure Patients.

Circulation. 2019 Mar 19. [Epub ahead of print]

DOI-link: 10.1161/CIRCULATIONAHA.118.036459


Further information:

Henrik Wiggers, Consultant, Department of Cardiology, Aarhus University Hospital, Tel.: +45 22 75 32 02, e-mail: henrwigg@rm.dk