Treatment With the Ketone Body 3-hydroxybutyrate in Patients With Acute Heart Failure
Treatment With the Ketone Body 3-hydroxybutyrate in Patients With Acute Heart Failure
Background:

 Acute heart failure is a potentially life-threatening condition, reaching mortality rates of
 up to 50% in advanced cases. The investigators have shown that infusion of ketone bodies
 increase cardiac output by 40% in stabile patients with chronic heart failure. However, there
 are no data showing the effects of ketone on patients with acute heart failure

 Objectives:

 To investigate the effect of ketone supplementation in patients with acute heart failure and
 cardiogenic shock, using two different types of oral ketone supplements.

 Methods:

 The investigators will conduct four randomized placebo-controlled studies, to investigate the
 hemodynamic effect of exogenous ketones in acute heart failure and cardiogenic shock.

 Perspectives:

 The present study will determine the potential beneficial effects of ketone supplements in
 patients with acute heart failure.
Inclusion Criteria:

 -  Hospitalized with worsening HF or de novo diagnosis of HF

 -  LVEF < 50%

 -  Treatment with intravenous loop diuretics during the hospitalization and/or increased
 dosage of oral diuretics.

 Exclusion Criteria:

 -  Cardiogenic shock

 -  Systolic Blood Pressure <85 mmHg

 -  Acute myocardial infarction other than type II <5 days prior to randomization *

 -  Severe uncorrected cardiac valve disease

 -  Expected or possible need for hemodialysis as judged by the investigator

 -  Ongoing inotropic treatment

 -  Possible need for advanced heart failure treatment (LVAD, heart transplantation) as
 judged by the investigator.

 -  Ongoing, severe infection

 -  Severe respiratory distress (SAT<90% or RF> 24/min or receiving more than 2 l O2/min
 or intubated)

 -  Atrial Fibrillation with heart >120 beats per minute

 -  Inability to cooperate to or accept oral intake of food, including presence of major
 gastrointestinal discomfort.

 -  If suspected or confirmed acute myocardial infarction as cause of acute heart
 failure, patients can be recruited 5 days after hospitalization in the absence of
 malignant arrhythmias (e.g. ventricular tachycardia) or clinically significant
 residual angina pectoris.