title: Urinary ketone is associated with the heart failure severity.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  Our results showed that urinary levels of ketone bodies are associated with the magnitude of echocardiographic parameters.
authors.affiliation: Cardiovascular Product Evaluation Center, Cardiovascular Research Institute, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Ji Hyung
authors.initials: JH
authors.lastname: Chung
authors.forename: Jin-Sup
authors.initials: JS
authors.lastname: Kim
authors.forename: Oh Yoen
authors.initials: OY
authors.lastname: Kim
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.forename: Geum-Sook
authors.initials: GS
authors.lastname: Hwang
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Shin
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology* / Q000652:urine*; D006801:Humans; D007659:Ketones / Q000652:urine*; D008297:Male; D009518:New York; D012044:Regression Analysis; D012720:Severity of Illness Index; D013318:Stroke Volume; D014463:Ultrasonography
chemical_list: D007659:Ketones