Evidence mapPaperPMID 39446133Full record

ArticleDiabetes2025

Effect of Hyperketonemia on Myocardial Function in Patients With Heart Failure and Type 2 Diabetes.

Carolina Solis-Herrera, Yuejuan Qin, Henri Honka, Eugenio Cersosimo, Curtis Triplitt, Sivaram Neppala, Jemena Rajan, Francisca M Acosta, Alexander J Moody, Patricia Iozzo and 3 more

Abstract read
In one paragraph

Article in Diabetes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Carolina Solis-HerreraDivision of Endocrinology, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.ORCID 0000-0002-6215-9418
Yuejuan QinDivision of Diabetes, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.
Henri HonkaDivision of Diabetes, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.
Eugenio CersosimoDivision of Diabetes, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.ORCID 0000-0002-2573-0208
Curtis TriplittDivision of Diabetes, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.
Sivaram NeppalaDivision of Diabetes, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.
Jemena RajanDivision of Diabetes, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.
Francisca M AcostaDepartment of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX.
Alexander J MoodyDepartment of Radiology and Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX.
Patricia IozzoInstitute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy.
Peter FoxDepartment of Radiology and Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX.
Geoffrey ClarkeDepartment of Radiology and Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX.
Ralph A DeFronzoDivision of Diabetes, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.ORCID 0000-0002-8581-6273

Funding

SGLT2 Inhibitors, Ketogenesis, and KetoacidosisR01DK024092 · NIDDK · YALE UNIVERSITY · 1986 to 2025
$3.6M
Ketones, Muscle Metabolism, and SGLT2 InhibitorsR01DK107680 · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · 2025 to 2025
$583k
Max and Minnie Tomerlin Voelcker FundMERCK PharmaceuticalsNIDDK/NIH R01DK24092NIDDK NIH HHS R01 DK024092NIDDK NIH HHS R01 DK107680
6 · The paper itself

Abstract

We examined the effect of increased levels of plasma ketones on left ventricular (LV) function, myocardial glucose uptake (MGU), and myocardial blood flow (MBF) in patients with type 2 diabetes (T2DM) with heart failure. Three groups of patients with T2DM (n = 12 per group) with an LV ejection fraction (EF) ≤50% received incremental infusions of β-hydroxybutyrate (β-OH-B) for 3-6 h to increase the plasma β-OH-B concentration throughout the physiologic (groups I and II) and pharmacologic (group III) range. Cardiac MRI was performed at baseline and after each β-OH-B infusion to provide measures of cardiac function. On a separate day, group II also received a sodium bicarbonate (NaHCO3) infusion, thus serving as their own control for time, volume, and pH. Additionally, group II underwent positron emission tomography study with 18F-fluoro-2-deoxyglucose to examine effect of hyperketonemia on MGU. Groups I, II, and III achieved plasma β-OH-B levels (mean ± SEM) of 0.7 ± 0.3, 1.6 ± 0.2, 3.2 ± 0.2 mmol/L, respectively. Cardiac output (CO), LVEF, and stroke volume (SV) increased significantly during β-OH-B infusion in groups II (CO, from 4.54 to 5.30; EF, 39.9 to 43.8; SV, 70.3 to 80.0) and III (CO, from 5.93 to 7.16; EF, 41.1 to 47.5; SV, 89.0 to 108.4), and did not change with NaHCO3 infusion in group II. The increase in LVEF was greatest in group III (P < 0.001 vs. group II). MGU and MBF were not altered by β-OH-B. In patients with T2DM and LVEF ≤50%, increased plasma β-OH-B level significantly increased LV function dose dependently. Because MGU did not change, the myocardial benefit of β-OH-B resulted from providing an additional fuel for the heart without inhibiting MGU. ARTICLE HIGHLIGHTS:

Indexed as

3-Hydroxybutyric AcidDiabetes Mellitus, Type 2Heart FailureAgedCoronary CirculationDiabetic KetoacidosisFemaleGlucoseHeartHumansMagnetic Resonance ImagingMaleMiddle AgedMyocardiumPositron-Emission TomographyStroke Volume3-Hydroxybutyric AcidGlucose

Identifiers

PMID39446133
PMCPMC11664025

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.