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World J Crit Care Med. Jun 9, 2026; 15(2): 117717
Published online Jun 9, 2026. doi: 10.5492/wjccm.v15.i2.117717
Published online Jun 9, 2026. doi: 10.5492/wjccm.v15.i2.117717
Effects of ketone bodies supplementation in patients with heart failure: A systematic review and meta-analysis
Ahmed K Siddiqi, Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta 30322, GA, United States
Syed S Javaid, Department of Medicine, University of Mississippi Medical Center, Jackson, MI 39216, United States
Akash Kumar, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro 76080, Sindh, Pakistan
Nomesh Kumar, Department of Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, MI 48210, United States
Mateen Ahmad, Department of Medicine, Allama Iqbal Medical College, Lahore 54570, Punjab, Pakistan
Shanzay Akhtar, Department of Medicine, Karachi Medical and Dental College, Karachi 75500, Sindh, Pakistan
Ahsan R Raja, Department of Medicine, Aga Khan University, Karachi 75950, Sindh, Pakistan
Diksha Ladhani, Nisha Kumari, Department of Medicine, Dow University of Health Sciences, Karachi 74200, Sindh, Pakistan
Sooraj Kumar, Department of Internal Medicine, Brookdale University Hospital and Medical Centre, New York, NY 11212, United States
Author contributions: Siddiqi AK, Javaid SS, Kumar A, and Ahmad M contributed to conceptualization, investigation, and methodology; Akhtar S, Raja AR, and Kumar S contributed to formal analysis, validation; Siddiqi AK, Javaid SS, Kumar A, Kumar N, Ahmad M, Akhtar S, Raja AR, Ladhani D, Kumari N, and Kumar S contributed to data curation, and manuscript review and editing; Kumar N, Ladhani D, and Kumari N contributed to visualization; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Akash Kumar, Doctorate Student, Researcher, Medical Research Center, Liaquat University of Medical and Health Sciences, Indus Highway, Jamshoro 76080, Sindh, Pakistan. akashdeewan4@gmail.com
Received: December 15, 2025
Revised: January 12, 2026
Accepted: April 13, 2026
Published online: June 9, 2026
Processing time: 158 Days and 12.1 Hours
Revised: January 12, 2026
Accepted: April 13, 2026
Published online: June 9, 2026
Processing time: 158 Days and 12.1 Hours
Core Tip
Core Tip: Metabolic modulation has emerged as a novel therapeutic strategy in heart failure (HF). This systematic review and meta-analysis of randomized controlled trials demonstrates that ketone body supplementation, particularly β-hydroxybutyrate, significantly improves cardiac output, left ventricular ejection fraction, and key hemodynamic parameters while reducing systemic vascular resistance and pulmonary capillary wedge pressure in patients with HF. These findings highlight the potential role of ketone bodies as an adjunctive metabolic therapy to enhance myocardial efficiency and hemodynamic performance, especially in HF with reduced ejection fraction.