Formation of ketone bodies in cases of functional heart failure

Abstract

Heart failure is increasing in both incidence and prevalence and is associated with high mortality. Pathophysiologic changes in heart failure have oeen linked to altered muscle function and hemodynamics, elevated neurohormones, and more recently, cellular mechanisms including apoptosis. (Parmley; 2000)

The present study was designed to assess whether ketone bodies are elevated in patients with heart failure (i.e. is heart failure a ketosis-prone state?). Whether the degree of ketonemia is related to the hemodynamic abnormalities as assessed by two- dimensional and Doppler echocardiography (to detect systolic and/ or diastolic dysfunction) or the prevailing neurohumoral milieu, including circulating norepinephrine concentration.

Another issue evaluated in our present study is the utility of using the serum level of ketone bodies (as represented by beta-hydroxybuterate) as an additive indicator of prognosis in patients with heart failure.

In this study 64 heart failure patients (32 men and 32 women) class I, II, Ill and IV according to the New York Heart Association functional classification with age ranging from 30- 50 years, who were v admitted to Kasr El Aini hospital internal medicine department were evaluated. The aetiology of heart failure in the studied patients was:

24 hypertensive, 12 ischemic heart disease. cardiomyopathy and 16 rheumatic valvular heart disease. 12 dilated Diabetic patients were excluded from our study. Estimation of kidney function, liver function and lipid profile was carried out in all patients. he studied heart failure patients were subjected to: