With trying to maintain training capacity and performance, as a cyclist, in heart failure, I have found the use of Ketone IQ very helpful. Although my personal observations are anecdotal. I use this product along with GU. I would love to perform a study (including myself) As to the sustaining and improving cardio-pulmonary function with the use of Ketone IQ, one without its use. It may prove to be an important adjunct treatment for individuals and athletes with heart disease ( including ATTR-CM) If you have any information on similar studies I’d be interested! Thanks!!! Scott Andersen