Acute Echocardiographic Effects of Exogenous Ketone Administration in Healthy Participants.

ABSTRACT (word count = 276) Background Interest in therapeutic applications of exogenous ketones has grown significantly, spanning heart failure patients to endurance athletes. Exogenous ketones engender significant effects on cardiac function in heart failure and provide an ergogenic benefit in athletes. We assessed the effects of exogenous ketones on cardiac function in healthy participants. Methods In a single-arm intervention study, twenty fasting, healthy participants underwent comprehensive echocardiography (2D/Doppler/strain) before and 30 minutes after weight-based oral ketone ester (KE) administration. The relationship between change in log-transformed biomarker levels with change in absolute global longitudinal strain (GLS) was assessed using linear regression. Results Mean age was 30 ± 7 years, 50% were female, 45% were non-white, and average BMI was 24.3 ± 3.1 kg/m2. Ketone ingestion acutely elevated beta-hydroxybutyrate levels (median, 25th-75th percentile) from 0.13 (0.10-0.37) to 3.23 (2.40-4.97) mmol/L (p Conclusions In a single-arm study, systolic blood pressure, heart rate, biventricular function, and LV/LA strain acutely augmented after KE ingestion in healthy, fasting participants, similar to several effects observed in the failing heart. These data may provide supporting data for the ergogenic benefits observed in athletes, and may become increasingly relevant with exogenous ketone consumption across a variety of cardiovascular and non-cardiovascular applications.