{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T19:05:11Z","timestamp":1788289511259,"version":"build-2803163510"},"reference-count":134,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01HL140954"],"award-info":[{"award-number":["R01HL140954"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"name":"GSU","award":["RS00020269"],"award-info":[{"award-number":["RS00020269"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Ketones are metabolites primarily produced by the liver and are utilized by various organs outside of the liver. Recent advances have demonstrated that ketones serve not only as alternative energy sources but also as signaling molecules. Research indicates that ketones can influence cancer development and metastasis, cardiac metabolic and structural remodeling, physical performance, vascular function, inflammation, and the aging process. Emerging evidence from preclinical and early-phase clinical studies suggests that strategies such as ketone salts, ketone esters, and the ketogenic diet may offer therapeutic benefits for conditions like heart failure, acute cardiac injury, diabetic cardiomyopathy, vascular complications, atherosclerosis, hypertension, and aortic aneurysm. This literature review updates the current understanding of ketone metabolism and its contributions to cardiovascular health and diseases. We highlight the underlying molecular mechanism with post-translational modification known as \u03b2-hydroxybutyrylation, which affects the fate and function of target proteins. Additionally, we discuss the therapeutic challenges associated with ketone therapy, the potential of using ketone levels as biomarkers for cardiovascular diseases, as well as gender- and age-specific differences in ketone treatment. Finally, we explore future research directions and what is needed to translate these new insights into cardiovascular medicine.<\/jats:p>","DOI":"10.3390\/cells15020150","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T12:04:22Z","timestamp":1768392262000},"page":"150","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ketones in Cardiovascular Health and Disease: An Updated Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3501-4487","authenticated-orcid":false,"given":"Sanjiv","family":"Shrestha","sequence":"first","affiliation":[{"name":"Institute for Biomedical Sciences, Georgia State University, 100 Piedmont Ave SE, Atlanta, GA 30303, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isis","family":"Harrison","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Sciences, Georgia State University, 100 Piedmont Ave SE, Atlanta, GA 30303, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminat","family":"Dosunmu","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Sciences, Georgia State University, 100 Piedmont Ave SE, Atlanta, GA 30303, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6143-4270","authenticated-orcid":false,"given":"Ping","family":"Song","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Sciences, Georgia State University, 100 Piedmont Ave SE, Atlanta, GA 30303, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1038\/s42255-025-01366-y","article-title":"An alternative route for beta-hydroxybutyrate metabolism supports cytosolic acetyl-CoA synthesis in cancer cells","volume":"7","author":"Kaluba","year":"2025","journal-title":"Nat. Metab."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1146\/annurev-nutr-111120-111518","article-title":"Metabolic and Signaling Roles of Ketone Bodies in Health and Disease","volume":"41","author":"Puchalska","year":"2021","journal-title":"Annu. Rev. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101328","DOI":"10.1016\/j.jacbts.2025.101328","article-title":"Ketone Bodies in Cardiovascular Disease","volume":"10","author":"Challa","year":"2025","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ciafardini, A., Vena, W., Betella, N., Pigni, S., Mirani, M., Altieri, V.M., Mazziotti, G., Lania, A.G., and Bossi, A.C. (Endocr. Metab. Immune Disord. Drug Targets, 2025). Diabetic Ketoacidosis: Considerations and Residual Controversies in Management After the 2024 ADA, EASD, JBDS, AACE, and DST Joint Consensus, Endocr. Metab. Immune Disord. Drug Targets, in press.","DOI":"10.2174\/0118715303374972250407065308"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1016\/j.jacc.2020.12.065","article-title":"Therapeutic Potential of Ketone Bodies for Patients with Cardiovascular Disease","volume":"77","author":"Yurista","year":"2021","journal-title":"JACC"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1113\/JP273185","article-title":"Metabolism of ketone bodies during exercise and training: Physiological basis for exogenous supplementation","volume":"595","author":"Evans","year":"2017","journal-title":"J. Physiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"C551","DOI":"10.1152\/ajpcell.00501.2023","article-title":"The therapeutic potential of ketones in cardiometabolic disease: Impact on heart and skeletal muscle","volume":"326","author":"Soni","year":"2024","journal-title":"Am. J. Physiol.-Cell Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2062","DOI":"10.1038\/s42255-023-00935-3","article-title":"Metabolic Messengers: Ketone bodies","volume":"5","author":"Nelson","year":"2023","journal-title":"Nat. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.molcel.2016.03.036","article-title":"Metabolic Regulation of Gene Expression by Histone Lysine beta-Hydroxybutyrylation","volume":"62","author":"Xie","year":"2016","journal-title":"Mol. Cell"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"eabe2771","DOI":"10.1126\/sciadv.abe2771","article-title":"The regulatory enzymes and protein substrates for the lysine beta-hydroxybutyrylation pathway","volume":"7","author":"Huang","year":"2021","journal-title":"Sci. Adv."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Vel\u00e1zquez, L., and Massieu, L. (2023). The proteomic effects of ketone bodies: Implications for proteostasis and brain proteinopathies. Front. Mol. Neurosci., 16.","DOI":"10.3389\/fnmol.2023.1214092"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"C143","DOI":"10.1152\/ajpcell.00485.2023","article-title":"Defining ketone supplementation: The evolving evidence for postexercise ketone supplementation to improve recovery and adaptation to exercise","volume":"326","author":"Robberechts","year":"2024","journal-title":"Am. J. Physiol.-Cell Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"6592","DOI":"10.1038\/s41467-025-61541-3","article-title":"\u03b2-Hydroxybutyrate promotes cancer metastasis through \u03b2-hydroxybutyrylation-dependent stabilization of Snail","volume":"16","author":"Jiang","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.aehs.2025.05.004","article-title":"Ketone bodies in exercise, health and disease: Metabolic mechanisms, pathophysiology, and therapeutic implications","volume":"2","author":"Li","year":"2025","journal-title":"Adv. Exerc. Health Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Hirschberger, S., Gellert, L., Effinger, D., Muenchhoff, M., Herrmann, M., Briegel, J.M., Zwi\u00dfler, B., and Kreth, S. (2022). Ketone Bodies Improve Human CD8+ Cytotoxic T-Cell Immune Response During COVID-19 Infection. Front. Med., 9.","DOI":"10.3389\/fmed.2022.923502"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e70067","DOI":"10.1111\/sji.70067","article-title":"Beyond Energy Fuel: Ketone Bodies as Multifaceted Modulators of T Cell and Anti-Tumour Immunity","volume":"102","author":"Gu","year":"2025","journal-title":"Scand. J. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Dy\u0144ka, D., Kowalcze, K., Charuta, A., and Paziewska, A. (2023). The Ketogenic Diet and Cardiovascular Diseases. Nutrients, 15.","DOI":"10.3390\/nu15153368"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1161\/CIRCRESAHA.123.321872","article-title":"Ketones and the Heart: Metabolic Principles and Therapeutic Implications","volume":"132","author":"Matsuura","year":"2023","journal-title":"Circ. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1038\/s44161-023-00259-1","article-title":"Ketones and the cardiovascular system","volume":"2","author":"Lopaschuk","year":"2023","journal-title":"Nat. Cardiovasc. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1093\/cvr\/cvz045","article-title":"Increased ketone body oxidation provides additional energy for the failing heart without improving cardiac efficiency","volume":"115","author":"Ho","year":"2019","journal-title":"Cardiovasc. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.cardfail.2025.01.028","article-title":"Therapeutic Ketosis for Heart Failure: A State-of-the-Art Review","volume":"31","author":"Kodur","year":"2025","journal-title":"J. Card. Fail."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.tem.2021.07.006","article-title":"Ketone bodies for the failing heart: Fuels that can fix the engine?","volume":"32","author":"Yurista","year":"2021","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1161\/hc3201.092286","article-title":"Upregulation of the cardiac monocarboxylate transporter MCT1 in a rat model of congestive heart failure","volume":"104","author":"Lunde","year":"2001","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4224","DOI":"10.1038\/s41467-025-59591-8","article-title":"Impaired ketogenesis in Leydig Cells drives testicular aging","volume":"16","author":"Liu","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1038\/s42255-025-01378-8","article-title":"Early-life ketone body signalling promotes beige fat biogenesis through changes in histone acetylome and \u03b2-hydroxybutyrylome","volume":"7","author":"Jiang","year":"2025","journal-title":"Nat. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1093\/cvr\/cvae231","article-title":"Advances in myocardial energy metabolism: Metabolic remodelling in heart failure and beyond","volume":"120","author":"Sun","year":"2024","journal-title":"Cardiovasc. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1093\/cvr\/cvaa143","article-title":"Ketones can become the major fuel source for the heart but do not increase cardiac efficiency","volume":"117","author":"Ho","year":"2021","journal-title":"Cardiovasc. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.2337\/db25-0243","article-title":"The Cardiac and Hemodynamic Effects of Ketone Bodies Are Abnormal in Patients with Type 1 Diabetes: A Randomized Controlled Trial","volume":"74","author":"Bangshaab","year":"2025","journal-title":"Diabetes"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Chevli, P.A., Selvaraj, S., Jaeger, B.C., Hammoud, A., Connelly, M.A., deFilippi, C., Lima, J.A.C., Khan, S.S., Herrington, D.M., and Shapiro, M.D. (2025). Integrating Ketone Bodies in Multi-Marker Risk Prediction of Incident Heart Failure in the Multi-Ethnic Study of Atherosclerosis (MESA). Eur. J. Prev. Cardiol., zwaf168.","DOI":"10.1093\/eurjpc\/zwaf168"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kansakar, U., Nieves Garcia, C., Santulli, G., Gambardella, J., Mone, P., Jankauskas, S.S., and Lombardi, A. (2024). Exogenous Ketones in Cardiovascular Disease and Diabetes: From Bench to Bedside. J. Clin. Med., 13.","DOI":"10.3390\/jcm13237391"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s13668-025-00631-6","article-title":"Correction to: Nutritional Ketosis for Weight Management and Reversal of Metabolic Syndrome","volume":"14","author":"Gershuni","year":"2025","journal-title":"Curr. Nutr. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.cmet.2016.12.022","article-title":"Multi-dimensional Roles of Ketone Bodies in Fuel Metabolism, Signaling, and Therapeutics","volume":"25","author":"Puchalska","year":"2017","journal-title":"Cell Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3949\/ccjm.92a.24089","article-title":"Hyperglycemic crises in adults: A look at the 2024 consensus report","volume":"92","year":"2025","journal-title":"Clevel. Clin. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Chu, Y., Zhang, C., and Xie, M. (2021). Beta-Hydroxybutyrate, Friend or Foe for Stressed Hearts. Front. Aging, 2.","DOI":"10.3389\/fragi.2021.681513"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1161\/CIRCULATIONAHA.124.071608","article-title":"Ketone Treatment in Heart Failure with Preserved Ejection Fraction: Recharging the Heart or Reducing Filling Pressures?","volume":"150","author":"Voorrips","year":"2024","journal-title":"Circulation"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1161\/CIRCULATIONAHA.122.061846","article-title":"Myocardial Metabolomics of Human Heart Failure with Preserved Ejection Fraction","volume":"147","author":"Hahn","year":"2023","journal-title":"Circulation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"156465","DOI":"10.1016\/j.metabol.2025.156465","article-title":"Epicardial adipose tissue produces L-3-hydroxybutyrate in advanced heart failure: Direct analysis of fat metabolic remodeling","volume":"175","author":"Riecan","year":"2026","journal-title":"Metabolism"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3556","DOI":"10.1093\/cvr\/cvac166","article-title":"Cardiac metabolism in HFpEF: From fuel to signalling","volume":"118","author":"Capone","year":"2023","journal-title":"Cardiovasc. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1161\/CIRCRESAHA.124.325550","article-title":"The Heart Has Intrinsic Ketogenic Capacity that Mediates NAD+ Therapy in HFpEF","volume":"136","author":"Koay","year":"2025","journal-title":"Circ. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1002\/ehf2.15319","article-title":"Alterations of myocardial ketone metabolism in heart failure with preserved ejection fraction (HFpEF)","volume":"12","author":"Sun","year":"2025","journal-title":"ESC Heart Fail."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1007\/s11897-024-00678-6","article-title":"Metabolic Adaptation in Heart Failure and the Role of Ketone Bodies as Biomarkers","volume":"21","author":"Foster","year":"2024","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_42","first-page":"100432","article-title":"Circulating acetoacetate is associated with poor prognosis in heart failure patients","volume":"25","author":"Yokokawa","year":"2019","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e13468","DOI":"10.1111\/eci.13468","article-title":"Association of beta-hydroxybutyrate with development of heart failure: Sex differences in a Dutch population cohort","volume":"51","author":"Westenbrink","year":"2021","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Jain, V., Chevli, P.A., Garg, P.K., McParland, J.T., Kizer, J., Mukamal, K., Schaich, C.L., Rikhi, R., Connelly, M., and Pandey, A. (2025). Circulating ketone bodies and risk of incident atrial fibrillation: Insights from the MESA and UK Biobank cohorts. Eur. J. Prev. Cardiol., zwaf543.","DOI":"10.1093\/eurjpc\/zwaf543"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s12265-024-10569-9","article-title":"\u03b2-Hydroxybutyrate and Citrate Synthase as Potential Diagnostic Biomarkers in Aging-Related Atrial Fibrillation","volume":"18","author":"He","year":"2025","journal-title":"J. Cardiovasc. Transl. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/EC9.0000000000000132","article-title":"A retrospective study on the relationship between plasma \u03b2-hydroxybutyric acid levels and short-term prognosis of cardiac function in patients with acute myocardial infarction combined with heart failure","volume":"5","author":"Wang","year":"2025","journal-title":"Emerg. Crit. Care Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"eaay8329","DOI":"10.1126\/scitranslmed.aay8329","article-title":"Elevated plasma \u03b2-hydroxybutyrate predicts adverse outcomes and disease progression in patients with arrhythmogenic cardiomyopathy","volume":"12","author":"Song","year":"2020","journal-title":"Sci. Transl. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11883-025-01333-8","article-title":"Salutary Effects of Nutritional Ketosis for the Diseased Human Heart","volume":"27","author":"Crabtree","year":"2025","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Saris, C.G.J., and Timmers, S. (2022). Ketogenic diets and Ketone suplementation: A strategy for therapeutic intervention. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.947567"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Mohib, O., Bomans, S., Jimenez Garcia, B., Leemans, L., Ligneel, C., De Waele, E., Beckw\u00e9e, D., and Janssens, P. (2025). Clinical Benefits of Exogenous Ketosis in Adults with Disease: A Systematic Review. Nutrients, 17.","DOI":"10.3390\/nu17193125"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3282","DOI":"10.1111\/epi.18465","article-title":"Serial correlation between saliva and blood beta-hydroxybutyrate levels in children commencing the ketogenic diet for epilepsy","volume":"66","author":"Kaul","year":"2025","journal-title":"Epilepsia"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"19","DOI":"10.14283\/jpad.2020.53","article-title":"Assessing the Impact of Factors that Influence the Ketogenic Response to Varying Doses of Medium Chain Triglyceride (MCT) Oil","volume":"8","author":"Juby","year":"2021","journal-title":"J. Prev. Alzheimer\u2019s Dis."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Daines, S.A. (2021). The Therapeutic Potential and Limitations of Ketones in Traumatic Brain Injury. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.723148"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/dom.14562","article-title":"A novel hypothesis linking low-grade ketonaemia to cardio-renal benefits with sodium-glucose cotransporter-2 inhibitors","volume":"24","author":"Ekanayake","year":"2022","journal-title":"Diabetes Obes. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Stubbs, B.J., Cox, P.J., Evans, R.D., Santer, P., Miller, J.J., Faull, O.K., Magor-Elliott, S., Hiyama, S., Stirling, M., and Clarke, K. (2017). On the Metabolism of Exogenous Ketones in Humans. Front. Physiol., 8.","DOI":"10.3389\/fphys.2017.00848"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Cuenoud, B., Hartweg, M., Godin, J.P., Croteau, E., Maltais, M., Castellano, C.A., Carpentier, A.C., and Cunnane, S.C. (2020). Metabolism of Exogenous D-Beta-Hydroxybutyrate, an Energy Substrate Avidly Consumed by the Heart and Kidney. Front. Nutr., 7.","DOI":"10.3389\/fnut.2020.00013"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Stefan, M., Sharp, M., Gheith, R., Lowery, R., and Wilson, J. (2021). The Effect of Exogenous Beta-Hydroxybutyrate Salt Supplementation on Metrics of Safety and Health in Adolescents. Nutrients, 13.","DOI":"10.3390\/nu13030854"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s40279-022-01756-2","article-title":"Exogenous Ketone Supplements in Athletic Contexts: Past, Present, and Future","volume":"52","author":"Evans","year":"2022","journal-title":"Sports Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1123\/ijsnem.2018-0284","article-title":"The Effect of 1,3-Butanediol on Cycling Time-Trial Performance","volume":"29","author":"Shaw","year":"2019","journal-title":"Int. J. Sport. Nutr. Exerc. Metab."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2630565","DOI":"10.1155\/2018\/2630565","article-title":"The Effect of Medium Chain Triglycerides on Time to Nutritional Ketosis and Symptoms of Keto-Induction in Healthy Adults: A Randomised Controlled Clinical Trial","volume":"2018","author":"Harvey","year":"2018","journal-title":"J. Nutr. Metab."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s42494-024-00199-8","article-title":"Exploring physiological beta-hydroxybutyrate level in children treated with the classical ketogenic diet for drug-resistant epilepsy","volume":"7","author":"Qiao","year":"2025","journal-title":"Acta Epileptol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/dom.13650","article-title":"A review of the mechanism of action, metabolic profile and haemodynamic effects of sodium-glucose co-transporter-2 inhibitors","volume":"21","author":"Brown","year":"2019","journal-title":"Diabetes Obes. Metab."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1093\/cvr\/cvae006","article-title":"Mitochondrial fatty acid oxidation is the major source of cardiac adenosine triphosphate production in heart failure with preserved ejection fraction","volume":"120","author":"Sun","year":"2024","journal-title":"Cardiovasc. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1038\/s42255-020-00310-6","article-title":"Ketone bodies for the starving heart","volume":"2","author":"Schulze","year":"2020","journal-title":"Nat. Metab."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1126\/science.abc8861","article-title":"Comprehensive quantification of fuel use by the failing and nonfailing human heart","volume":"370","author":"Murashige","year":"2020","journal-title":"Science"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1161\/CIRCULATIONAHA.118.036459","article-title":"Cardiovascular Effects of Treatment with the Ketone Body 3-Hydroxybutyrate in Chronic Heart Failure Patients","volume":"139","author":"Nielsen","year":"2019","journal-title":"Circulation"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e039750","DOI":"10.1161\/JAHA.124.039750","article-title":"Metabolomics Profiling of Epicardial Adipose Tissue: MESA and the Rotterdam Study","volume":"14","author":"Neeland","year":"2025","journal-title":"J. Am. Heart Assoc."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e033628","DOI":"10.1161\/JAHA.123.033628","article-title":"Enantiomer-Specific Cardiovascular Effects of the Ketone Body 3-Hydroxybutyrate","volume":"13","author":"Gopalasingam","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Kolwicz, S.C. (2021). Ketone Body Metabolism in the Ischemic Heart. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.789458"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1186\/s12933-024-02221-2","article-title":"Ketone body levels and its associations with cardiac markers following an acute myocardial infarction: A post hoc analysis of the EMMY trial","volume":"23","author":"Aziz","year":"2024","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/j.jacc.2021.07.054","article-title":"Association of Circulating Ketone Bodies with Functional Outcomes After ST-Segment Elevation Myocardial Infarction","volume":"78","author":"Koning","year":"2021","journal-title":"JACC"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"20230793","DOI":"10.1515\/med-2023-0793","article-title":"Elevated blood acetoacetate levels reduce major adverse cardiac and cerebrovascular events risk in acute myocardial infarction","volume":"18","author":"Sato","year":"2023","journal-title":"Open Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"155608","DOI":"10.1016\/j.metabol.2023.155608","article-title":"Ketone ester supplementation suppresses cardiac inflammation and improves cardiac energetics in a swine model of acute myocardial infarction","volume":"145","author":"Yurista","year":"2023","journal-title":"Metabolism"},{"key":"ref_74","first-page":"e015298","article-title":"Cardioprotective Effect of Empagliflozin and Circulating Ketone Bodies During Acute Myocardial Infarction","volume":"16","author":"Picatoste","year":"2023","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.yjmcc.2023.11.001","article-title":"\u03b2-hydroxybutyrate administered at reperfusion reduces infarct size and preserves cardiac function by improving mitochondrial function through autophagy in male mice","volume":"186","author":"Chu","year":"2024","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1161\/CIRCRESAHA.124.325179","article-title":"beta-Hydroxybutyrate Facilitates Postinfarction Cardiac Repair via Targeting PHD2","volume":"136","author":"Wang","year":"2025","journal-title":"Circ. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s00395-025-01103-2","article-title":"The ketone body 3-hydroxybutyrate increases cardiac output and cardiac contractility in a porcine model of cardiogenic shock: A randomized, blinded, crossover trial","volume":"120","author":"Larsen","year":"2025","journal-title":"Basic Res. Cardiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s00395-023-01008-y","article-title":"Ketone body 3-hydroxybutyrate elevates cardiac output through peripheral vasorelaxation and enhanced cardiac contractility","volume":"118","author":"Homilius","year":"2023","journal-title":"Basic. Res. Cardiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"112461","DOI":"10.1016\/j.diabres.2025.112461","article-title":"Beta-hydroxybutyrate ameliorates cardiac fibrosis in diabetic cardiomyopathy rats via regulating macrophage polarization","volume":"229","author":"He","year":"2025","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e028232","DOI":"10.1161\/JAHA.122.028232","article-title":"Hemodynamic Effects of Ketone Bodies in Patients With Pulmonary Hypertension","volume":"12","author":"Nielsen","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2003410","DOI":"10.1002\/advs.202003410","article-title":"Ketone Body 3-Hydroxybutyrate Ameliorates Atherosclerosis via Receptor Gpr109a-Mediated Calcium Influx","volume":"8","author":"Zhang","year":"2021","journal-title":"Adv. Sci."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Krishnan, M., Hwang, J.S., Kim, M., Kim, Y.J., Seo, J.H., Jung, J., and Ha, E. (2020). \u03b2-hydroxybutyrate Impedes the Progression of Alzheimer\u2019s Disease and Atherosclerosis in ApoE-Deficient Mice. Nutrients, 12.","DOI":"10.3390\/nu12020471"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Chen, Y., You, Y., Wang, X., Jin, Y., Zeng, Y., Pan, Z., Li, D., and Ling, W. (2025). \u03b2-Hydroxybutyrate Alleviates Atherosclerotic Calcification by Inhibiting Endoplasmic Reticulum Stress-Mediated Apoptosis via AMPK\/Nrf2 Pathway. Nutrients, 17.","DOI":"10.3390\/nu17010111"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1002\/path.5992","article-title":"Downregulation of HDAC9 by the ketone metabolite beta-hydroxybutyrate suppresses vascular calcification","volume":"258","author":"Lan","year":"2022","journal-title":"J. Pathol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1161\/CIRCULATIONAHA.123.067971","article-title":"Cardiovascular Effects of Oral Ketone Ester Treatment in Patients with Heart Failure with Reduced Ejection Fraction: A Randomized, Controlled, Double-Blind Trial","volume":"149","author":"Gopalasingam","year":"2024","journal-title":"Circulation"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1161\/CIRCULATIONAHA.124.069732","article-title":"Randomized Crossover Trial of 2-Week Ketone Ester Treatment in Patients with Type 2 Diabetes and Heart Failure with Preserved Ejection Fraction","volume":"150","author":"Gopalasingam","year":"2024","journal-title":"Circulation"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1038\/s41392-020-00411-4","article-title":"Ketogenic diets inhibit mitochondrial biogenesis and induce cardiac fibrosis","volume":"6","author":"Xu","year":"2021","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"eado1463","DOI":"10.1126\/sciadv.ado1463","article-title":"Ketogenic diet induces p53-dependent cellular senescence in multiple organs","volume":"10","author":"Wei","year":"2024","journal-title":"Sci. Adv."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"101711","DOI":"10.1016\/j.molmet.2023.101711","article-title":"Ketogenic diets composed of long-chain and medium-chain fatty acids induce cardiac fibrosis in mice","volume":"72","author":"Sternberg","year":"2023","journal-title":"Mol. Metab."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Armani, A., Marzolla, V., Mammi, C., Vitiello, L., Bellucci, E., Feraco, A., Gorini, S., and Caprio, M. (2025). Protective effects of ketogenic diet on aldosterone-induced atherosclerosis in ApoE\u2212\/\u2212 mice. J. Endocrinol. Investig., 1\u20138.","DOI":"10.1007\/s40618-025-02740-z"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1038\/s41598-024-51996-7","article-title":"Ketosis prevents abdominal aortic aneurysm rupture through C-C chemokine receptor type 2 downregulation and enhanced extracellular matrix balance","volume":"14","author":"Arif","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1159\/000369702","article-title":"Hyperketonemia (acetoacetate) upregulates NADPH oxidase 4 and elevates oxidative stress, ICAM-1, and monocyte adhesivity in endothelial cells","volume":"35","author":"Jain","year":"2015","journal-title":"Cell Physiol. Biochem."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"7115","DOI":"10.1038\/s41467-021-27426-x","article-title":"Acetoacetate protects macrophages from lactic acidosis-induced mitochondrial dysfunction by metabolic reprograming","volume":"12","author":"Adam","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.celrep.2018.09.058","article-title":"Salt-Responsive Metabolite, \u03b2-Hydroxybutyrate, Attenuates Hypertension","volume":"25","author":"Chakraborty","year":"2018","journal-title":"Cell Rep."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/j.molcel.2018.07.036","article-title":"beta-Hydroxybutyrate Prevents Vascular Senescence through hnRNP A1-Mediated Upregulation of Oct4","volume":"71","author":"Han","year":"2018","journal-title":"Mol. Cell"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Venturini, C., Mancinelli, L., Matacchione, G., Olivieri, F., and Antonicelli, R. (2024). The Cardioprotective Effects of Nutritional Ketosis: Mechanisms and Clinical Implications. Nutrients, 16.","DOI":"10.3390\/nu16234204"},{"key":"ref_97","first-page":"e24","article-title":"Correction to: Targeting Mitochondria-Inflammation Circuit by \u03b2-Hydroxybutyrate Mitigates HFpEF","volume":"130","author":"Deng","year":"2022","journal-title":"Circ. Res."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"4697","DOI":"10.2147\/JIR.S331320","article-title":"\u03b2-Hydroxybutyrate Mitigated Heart Failure with Preserved Ejection Fraction by Increasing Treg Cells via Nox2\/GSK-3\u03b2","volume":"14","author":"Liao","year":"2021","journal-title":"J. Inflamm. Res."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e21098","DOI":"10.1016\/j.heliyon.2023.e21098","article-title":"\u03b2-Hydroxybutyrate as an epigenetic modifier: Underlying mechanisms and implications","volume":"9","author":"He","year":"2023","journal-title":"Heliyon"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.jacbts.2024.11.004","article-title":"\u03b2-Hydroxybutyrate Facilitates Homeostasis of Hypoxic Endothelial Cells After Myocardial Infarction via Histone Lysine \u03b2-Hydroxybutyrylation of CPT1A","volume":"10","author":"Li","year":"2025","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.jacbts.2025.03.006","article-title":"From Fuel to Code","volume":"10","author":"Hurk","year":"2025","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Kuppuswamy, S., Patel, K., Zhi, W., and Ganta, V. (2025). The Pro-vs. Anti-Angiogenic Capacity of Short Chain Fatty Acids is Dependent on the Bioavailability of FFAR3 in Peripheral Artery Disease. bioRxiv.","DOI":"10.1101\/2025.02.20.639393"},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Carbone, A.M., Borges, J.I., Suster, M.S., Sizova, A., Cora, N., Desimine, V.L., and Lymperopoulos, A. (2022). Regulator of G-Protein Signaling-4 Attenuates Cardiac Adverse Remodeling and Neuronal Norepinephrine Release-Promoting Free Fatty Acid Receptor FFAR3 Signaling. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23105803"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1038\/s41419-019-1463-y","article-title":"p53 \u03b2-hydroxybutyrylation attenuates p53 activity","volume":"10","author":"Liu","year":"2019","journal-title":"Cell Death Dis."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2337\/db25-0496","article-title":"\u03b2-Hydroxybutyrylation Links Ketone Metabolism to Mitochondrial Remodeling in Diabetic Cardiomyopathy","volume":"75","author":"Jing","year":"2025","journal-title":"Diabetes"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"e14368","DOI":"10.1111\/acel.14368","article-title":"Ketogenic \u03b2-hydroxybutyrate regulates \u03b2-hydroxybutyrylation of TCA cycle-associated enzymes and attenuates disease-associated pathologies in Alzheimer\u2019s mice","volume":"24","author":"Han","year":"2025","journal-title":"Aging Cell"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41388-025-03644-1","article-title":"TAF1 acetyltransferase promotes colorectal carcinoma metastasis by catalyzing \u03b2-hydroxybutyrylation of KCTD9","volume":"45","author":"Su","year":"2025","journal-title":"Oncogene"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1038\/s42003-025-08832-z","article-title":"Hippocampal CaMKII-\u03b1 \u03b2-hydroxybutyrylation induces memory deficits in mice with type 1 diabetes mellitus","volume":"8","author":"Li","year":"2025","journal-title":"Commun. Biol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"103949","DOI":"10.1016\/j.redox.2025.103949","article-title":"\u03b2-Hydroxybutyrate ameliorates lipopolysaccharide-induced liver injury through \u03b2-hydroxybutyrylation of the SOD2 protein in mice","volume":"88","author":"Bai","year":"2025","journal-title":"Redox Biol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"108475","DOI":"10.1016\/j.jbc.2025.108475","article-title":"\u03b2-hydroxybutyrate serves as a regulator in ketone body metabolism through lysine \u03b2-hydroxybutyrylation","volume":"301","author":"Fang","year":"2025","journal-title":"J. Biol. Chem."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1038\/s41419-024-07268-3","article-title":"\u03b2-Hydroxybutyrate suppresses M1 macrophage polarization through \u03b2-hydroxybutyrylation of the STAT1 protein","volume":"15","author":"Bai","year":"2024","journal-title":"Cell Death Dis."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e007684","DOI":"10.1161\/CIRCHEARTFAILURE.120.007684","article-title":"Ketone Ester Treatment Improves Cardiac Function and Reduces Pathologic Remodeling in Preclinical Models of Heart Failure","volume":"14","author":"Yurista","year":"2021","journal-title":"Circ. Heart Fail."},{"key":"ref_113","first-page":"e012167","article-title":"Neurohormonal and Renal Effects of 14-Day Oral Ketone Ester Treatment in Patients with Heart Failure with Reduced Ejection Fraction","volume":"18","author":"Gopalasingam","year":"2025","journal-title":"Circ. Heart Fail."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"e038461","DOI":"10.1161\/JAHA.124.038461","article-title":"Cardiovascular and Metabolic Effects of Modulating Circulating Ketone Bodies with 1,3-Butanediol in Patients with Heart Failure with Reduced Ejection Fraction","volume":"14","author":"Guldbrandsen","year":"2025","journal-title":"J. Am. Heart Assoc."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2337\/db24-0406","article-title":"Effect of Hyperketonemia on Myocardial Function in Patients with Heart Failure and Type 2 Diabetes","volume":"74","author":"Qin","year":"2025","journal-title":"Diabetes"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"22805","DOI":"10.1038\/s41598-024-73384-x","article-title":"The ketogenic diet has the potential to decrease all-cause mortality without a concomitant increase in cardiovascular-related mortality","volume":"14","author":"Qu","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"C1416","DOI":"10.1152\/ajpcell.00241.2024","article-title":"Emerging roles of ketone bodies in cardiac fibrosis","volume":"327","author":"Maduray","year":"2024","journal-title":"Am. J. Physiol.-Cell Physiol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.jacbts.2023.03.014","article-title":"Ketone Bodies Rescue Mitochondrial Dysfunction Via Epigenetic Remodeling","volume":"8","author":"Gambardella","year":"2023","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"5606","DOI":"10.1002\/ehf2.13634","article-title":"Chronic exogenous ketone supplementation blunts the decline of cardiac function in the failing heart","volume":"8","author":"Takahara","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"e22227","DOI":"10.1016\/j.heliyon.2023.e22227","article-title":"Ketone bodies in right ventricular failure: A unique therapeutic opportunity","volume":"9","author":"Blake","year":"2023","journal-title":"Heliyon"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12986-020-00510-7","article-title":"Ketogenic diet aggravates cardiac remodeling in adult spontaneously hypertensive rats","volume":"17","author":"You","year":"2020","journal-title":"Nutr. Metab."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"4253651","DOI":"10.1155\/2022\/4253651","article-title":"Alternate-Day Ketogenic Diet Feeding Protects against Heart Failure through Preservation of Ketogenesis in the Liver","volume":"2022","author":"Guo","year":"2022","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"10210","DOI":"10.1039\/D1FO02288A","article-title":"Ketogenic diet aggravates colitis, impairs intestinal barrier and alters gut microbiota and metabolism in DSS-induced mice","volume":"12","author":"Li","year":"2021","journal-title":"Food Funct."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"eadx2752","DOI":"10.1126\/sciadv.adx2752","article-title":"A long-term ketogenic diet causes hyperlipidemia, liver dysfunction, and glucose intolerance from impaired insulin secretion in mice","volume":"11","author":"Gallop","year":"2025","journal-title":"Sci. Adv."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Sprankle, K.W., Knappenberger, M.A., Locke, E.J., Thompson, J.H., Vinovrski, M.F., Knapsack, K., and Kolwicz, S.C. (2024). Sex- and Age-Specific Differences in Mice Fed a Ketogenic Diet. Nutrients, 16.","DOI":"10.3390\/nu16162731"},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Moss, S.E., Poff, A.M., Moss, A., DeBlasi, J.M., and D\u2019Agostino, D.P. (2025). From glucose to histone modification: Sex-specific metabolic responses to ketogenic therapy in VM\/Dk mice. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1554743"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"bvaf131","DOI":"10.1210\/jendso\/bvaf131","article-title":"Sex Differences in Ketogenic Diet Response Reveal Gonadal Hormone Interaction with FGF21 in Mice","volume":"9","author":"Zhang","year":"2025","journal-title":"J. Endocr. Soc."},{"key":"ref_128","doi-asserted-by":"crossref","unstructured":"Ataran, A., Pompian, A., Hajirezaei, H., Lodhi, R., and Javaheri, A. (2024). Fueling the Heart: What Are the Optimal Dietary Strategies in Heart Failure?. Nutrients, 16.","DOI":"10.20944\/preprints202408.0308.v1"},{"key":"ref_129","doi-asserted-by":"crossref","unstructured":"Zala, S.M., Santos, R., Strasser, E., Schadde, A., Kugler, S., Strauss, V., K\u00fcbber-Heiss, A., and Zala, D. (2025). Sex-dependent effects of a gestational ketogenic diet on offspring birth and lifespan. PLoS ONE, 20.","DOI":"10.1101\/2025.02.19.639045"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"116026","DOI":"10.1016\/j.celrep.2025.116026","article-title":"Divergent sex-specific effects on a ketogenic diet: Male, but not female, mice exhibit oxidative stress and cellular senescence","volume":"44","author":"Wei","year":"2025","journal-title":"Cell Rep."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41420-025-02372-5","article-title":"Different types of cell death and their interactions in myocardial ischemia\u2013reperfusion injury","volume":"11","author":"Du","year":"2025","journal-title":"Cell Death Discov."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1093\/nutrit\/nuaf010","article-title":"The Impact of Ketogenic Nutrition on Obesity and Metabolic Health: Mechanisms and Clinical Implications","volume":"83","author":"Biesiekierska","year":"2025","journal-title":"Nutr. Rev."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.cell.2024.10.032","article-title":"A \u03b2-hydroxybutyrate shunt pathway generates anti-obesity ketone metabolites","volume":"188","author":"Wang","year":"2025","journal-title":"Cell"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"111291","DOI":"10.1016\/j.isci.2024.111291","article-title":"The impact of a ketogenic diet on weight loss, metabolism, body composition and quality of life","volume":"27","author":"Hirschberger","year":"2024","journal-title":"iScience"}],"container-title":["Cells"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4409\/15\/2\/150\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T06:17:56Z","timestamp":1768544276000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4409\/15\/2\/150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":134,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["cells15020150"],"URL":"https:\/\/doi.org\/10.3390\/cells15020150","relation":{},"ISSN":["2073-4409"],"issn-type":[{"value":"2073-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]}}}