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Mechanisms identified include: increased cardiac utilization of ketones increased autophagy (recycling of intracellular components)l decreased inflammation & oxidative stress improved mitochondrial function decreased intracellular Ca & Na overload decreased fibrosis improved myocardial diastolic function decrease myocardial hypertrophy Figure 1

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Cell-based assays and in vitro systems are used by scientists to study the binding properties, structural stability, and signaling activity under controlled conditions