{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:38:49Z","timestamp":1791851929812,"version":"4.3.4"},"reference-count":47,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100006772","name":"Max and Minnie Tomerlin Voelcker Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006772","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIDDK\/NIH","award":["R01DK24092"],"award-info":[{"award-number":["R01DK24092"]}]},{"name":"MERCK Pharmaceuticals"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n                  <jats:p>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) \u226450% received incremental infusions of \u03b2-hydroxybutyrate (\u03b2-OH-B) for 3\u20136 h to increase the plasma \u03b2-OH-B concentration throughout the physiologic (groups I and II) and pharmacologic (group III) range. Cardiac MRI was performed at baseline and after each \u03b2-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 \u03b2-OH-B levels (mean \u00b1 SEM) of 0.7 \u00b1 0.3, 1.6 \u00b1 0.2, 3.2 \u00b1 0.2 mmol\/L, respectively. Cardiac output (CO), LVEF, and stroke volume (SV) increased significantly during \u03b2-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 &amp;lt; 0.001 vs. group II). MGU and MBF were not altered by \u03b2-OH-B. In patients with T2DM and LVEF \u226450%, increased plasma \u03b2-OH-B level significantly increased LV function dose dependently. Because MGU did not change, the myocardial benefit of \u03b2-OH-B resulted from providing an additional fuel for the heart without inhibiting MGU.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Article Highlights<\/jats:title>\n               <\/jats:sec>","DOI":"10.2337\/db24-0406","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T14:57:28Z","timestamp":1729781848000},"page":"43-52","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":11,"title":["Effect of Hyperketonemia on Myocardial Function in Patients With Heart Failure and Type 2 Diabetes"],"prefix":"10.2337","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6215-9418","authenticated-orcid":false,"given":"Carolina","family":"Solis-Herrera","sequence":"first","affiliation":[{"name":"1Division of Endocrinology, Department of Medicine, University of Texas Health Science 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Structural Biology, University of Texas Health Science Center, San Antonio, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Moody","sequence":"additional","affiliation":[{"name":"6Department of Radiology and Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Iozzo","sequence":"additional","affiliation":[{"name":"7Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Fox","sequence":"additional","affiliation":[{"name":"6Department of Radiology and Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Clarke","sequence":"additional","affiliation":[{"name":"6Department of Radiology and Research Imaging 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