Urinary ketone is associated with the heart failure severity

Objectives: To test the hypothesis that urinary metabolites characterizing heart failure (HF) are associated with the magnitude of echocardiographic measurements and ultimately the severity of HF. Design/methods: Patients with systolic HF (n = 46) and control subjects (n = 32) participated in this study. Patients with type 2 diabetes mellitus were excluded. Echocardiographic measurements were performed, and selected urinary metabolites were quantified. Results: Urinary levels of acetate (p < 0.05), acetone (p < 0.01), cytosine (p < 0.001), methylmalonate (p < 0.001), and phenylacetylglycine (p < 0.01) were significantly higher, while 1-methylnicotinamide (p < 0.05) were significantly lower in HF patients than in controls. There were significant differences in E/E' (p < 0.05), urinary levels of acetate (p < 0.005), acetoacetate (p < 0.05), acetone (p < 0.05) and ketones (p < 0.01) according to the New York Heart Association (NYHA) classification in HF patients. Multiple linear regression analysis revealed that urinary ketones were found to be independent factors for both left ventricular ejection fraction and E/E' after adjusting for confounders. Conclusion: Our results showed that urinary levels of ketone bodies are associated with the magnitude of echocardiographic parameters.