The ketone bodies, d-β-hydroxybutyrate and acetoacetate, are soluble 4-carbon compounds derived principally from fatty acids, that can be metabolised by many oxidative tissues, including heart, in carbohydrate-depleted conditions as glucose-sparing energy substrates. They also have important signalling functions, acting through G-protein coupled receptors and histone deacetylases to regulate metabolism and gene expression including that associated with anti-oxidant activity. Their concentration, and hence availability, increases in diabetes mellitus and heart failure. Whilst known to be substrates for ATP production, especially in starvation, their role(s) in the heart, and in heart disease, is uncertain. Recent evidence, reviewed here, indicates that increased ketone body metabolism is a feature of heart failure, and is accompanied by other changes in substrate selection. Whether the change in myocardial ketone body metabolism is adaptive or maladaptive is unknown, but it offers the possibility of using exogenous ketones to treat the failing heart.

中文翻译：

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心脏酮体代谢。

酮体（d-β-羟基丁酸酯和乙酰乙酸酯）是主要衍生自脂肪酸的可溶性4碳化合物，可以在包括碳水化合物在内的许多氧化组织中，作为消耗葡萄糖的能量底物，被包括心脏在内的许多氧化性组织代谢。它们还具有重要的信号传导功能，通过G蛋白偶联受体和组蛋白脱乙酰基酶来调节新陈代谢和基因表达，包括与抗氧化活性有关的基因表达。它们的集中度以及因此的可获得性增加了糖尿病和心力衰竭。虽然已知是ATP生产的底物，尤其是在饥饿中，但尚不确定它们在心脏和心脏病中的作用。此处回顾的最新证据表明，酮体新陈代谢的增加是心力衰竭的特征，并伴随着底物选择的其他变化。心肌酮体新陈代谢的变化是适应性的还是适应不良的尚不清楚，但它提供了使用外源性酮治疗心脏衰竭的可能性。