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This study characterized cardiac function and blood flow responses to a ketogenic beverage compared to a volume\/calorie matched placebo with repeated imaging over 120\u2009min. This was a two\u2010group, placebo\u2010controlled, acute cardiac imaging study. Adults without cardiac abnormalities underwent baseline cardiac MRI including quantitative myocardial perfusion to measure myocardial blood flow (MBF). Subjects consumed 50\u2009g of a ketogenic\u2010promoting beverage [bis\u2010hexanoyl R\u20101\u20103\u2010butanediol (BH\u2010BD)] (BH\u2010BD; <jats:italic>n<\/jats:italic>\u2009=\u200911) or a calorically\/volume\u2010matched lipid\u2010based placebo (PL; <jats:italic>n<\/jats:italic>\u2009=\u200910) with cardiac MRI every 15\u201330\u2009min. Following 120\u2009min, subjects underwent a final scan including MBF measurement. R\u2010BHB and glucose were measured at every timepoint. 120\u2009min following BH\u2010BD consumption, R\u2010BHB reached 2.1\u2009mM. Cardiac output (CO) was elevated compared to PL (<jats:italic>p\u2009&lt;<\/jats:italic>\u20090.05) and increased +31% 120\u2009min after BH\u2010BD ingestion (<jats:italic>p\u2009&lt;<\/jats:italic>\u20090.001). CO elevation was due to increased stroke volume (+11%; <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and heart rate (+22%; <jats:italic>p\u2009&lt;<\/jats:italic>\u20090.001). MBF increased 29% from baseline (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). PL did not induce differences in cardiac parameters. 50\u2009g BH\u2010BD ingestion achieves exogenous ketosis and is associated with elevated MBF and CO providing evidence supporting their use as a therapeutic clinical agent.<\/jats:p>","DOI":"10.14814\/phy2.70208","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T04:21:06Z","timestamp":1742358066000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A ketogenic\u2010promoting beverage acutely elevates cardiac function and myocardial blood flow compared to placebo in adults: A cardiac <scp>MRI<\/scp> investigation"],"prefix":"10.14814","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7284-3048","authenticated-orcid":false,"given":"Christopher D.","family":"Crabtree","sequence":"first","affiliation":[{"name":"Department of Radiology The Ohio State University  Columbus Ohio USA"},{"name":"Department of Human 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