This systematic review and meta-analysis searched PubMed, Cochrane Library, and Embase through April 13, 2024, and included seven human studies of ketone therapy (ketone ester and beta-hydroxybutyrate) in heart failure. Ketone therapy significantly improved left ventricular ejection fraction (standardized mean difference 0.52, 95 percent CI 0.25 to 0.80), cardiac output (0.84), and stroke volume (0.47), and reduced systemic vascular resistance (-0.92) without changing mean arterial pressure (-0.09). Subgroup analysis found the effects also applied to individuals without heart failure.
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