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The elevated labeling of 2HB and propionylcarnitine in skeletal muscle can likely be attributed to the release of these metabolites from the liver, where SDS is significantly upregulated (Fig

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This mechanism is essential for maintaining energy homeostasis and promoting efficient energy utilization in various physiological processes

Additionally, during the progression of HFrEF, myocardial ketone body oxidation and impaired fatty acid oxidation occur simultaneously

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