D-Ribose: Building Block for a Healthy Heart

By VRP Staff

One of the most common cardiovascular concerns of our time is congestive heart failure (CHF). According to a Mayo Clinic study of 2,029 subjects, 56 percent of adults over age 45 had risk factors for congestive heart failure, including asymptomatic ventricular dysfunction.¹

CHF occurs when the heart muscle weakens. When this happens, the heart can’t pump a sufficient volume of blood to supply the body’s need for oxygen, a condition also known as ischemia. Hypertension, coronary artery disease and cardiomyopathy are all linked to the development of congestive heart failure and the accompanying systolic and diastolic cardiac dysfunction. With heart failure, many organs are deprived of enough oxygen and nutrients, and damage occurs.

Adenosine-5’-triphosphate (ATP) plays an integral role in heart function. ATP shuttles chemical energy within the cells for metabolism and is the main energy source for the majority of cellular functions, including DNA and RNA synthesis. If a person is stressed by poor heart function or over exertion in exercise, they need an increased ATP supply to recover properly.

During the oxygen-deprived state of ischemia, the heart loses as much as 50 percent of its ATP stores. Even after normal blood flow and oxygen levels are restored it can take as much as ten days for ATP levels to rebound enough for the heart to rebuild its cellular energy and normalize cardiac function.

D-Ribose is the exclusive sugar component of ATP and the nucleic acids DNA and RNA. As the building block for ATP, DNA and RNA, D-Ribose can help the heart recover from a low oxygen state.

Under certain abnormal cardiac conditions, nucleotides (particularly ATP, ADP, and AMP) are degraded and lost from the heart. The heart’s ability to resynthesize ATP is then limited by the supply of D-Ribose, which is a necessary component of ATP, ADP and AMP.

After cellular damage, DNA and RNA must be doubled for the cells to divide properly and repair themselves. Without D-Ribose, this repair process could not occur. D-Ribose, therefore, plays a critical role in recovery from injury through its ability to repair DNA and RNA and to increase ATP levels. However, the body’s rate of D-Ribose production is constant. It doesn’t accelerate according to need, which can have disastrous consequences for recovery efforts, especially during congestive heart failure and ischemic heart disease.

Researcher Heinz-Gerd Zimmer at the University of Munich pioneered much of the early work that made the connection between D-Ribose and heart function. Since the 1970s, Zimmer has conducted many animal studies that confirm D-Ribose’s cardiovascular effects. In rodents with depressed heart function and reduced ATP levels, D-Ribose, when continuously infused for 24 hours, prevented the ATP reduction that occurred in untreated animals, and normalized left ventricular function.²

Another of Zimmer’s studies explored D-Ribose’s effect in the heart muscle of rats after a low-oxygen (hypoxic) state was induced. Even after a brief period of ischemia, the heart is very slow at replenishing its ATP pool. Zimmer and his colleagues proved that continuous i.v. infusion of D-Ribose during recovery from 15 minutes of myocardial ischemia in rats leads to restoration of the cardiac ATP pool within 12 hours, whereas 72 hours are needed for ATP normalization without any intervention.³

In an animal model of heart transplantation, Zimmer and colleagues also found that D-Ribose treatment maintains ATP at a higher level in preserved rat hearts and that D-Ribose may be able to prolong the preservation time of donor hearts.⁴

John Foker, another researcher who recognized D-Ribose’s importance in heart health, produced myocardial ischemia in dogs, then, during the recovery phase, administered by infusion either D-Ribose or saline. In both the D-Ribose and saline groups, myocardial ATP levels fell by at least 50 percent at the end of ischemia. No significant ATP recovery occurred after 24 hours in the control dogs, but in the D-Ribose-treated animals, ATP levels rebounded by 85 percent by 24 hours.⁵

In a similar experiment, Foker found that it took 9.9 days for ATP levels to fully recover after ischemia in untreated dogs, but only 1.2 days to recover in dogs given a D-Ribose infusion.⁶

Recently, in a prospective, double blind, randomized, crossover design study, scientists assessed oral D-Ribose supplementation on cardiac function and quality of life in 15 patients with chronic coronary artery disease and congestive heart failure. The study consisted of two treatment periods of 3 weeks, during which either oral D-Ribose or placebo was administered. A 1-week wash out period followed, and then subjects who had been taking the placebo began taking the D-Ribose and subjects who had taken the D-Ribose took the placebo. The administration of D-Ribose enhanced left ventricular function and other markers of heart function. D-Ribose also resulted in a significant improvement of the patients’ quality of life. The placebo did not result in any improvements.⁷

In other studies, D-Ribose use in patients with stable coronary artery disease reduced exercise-induced angina.⁸

References

1. Ammar KA, Jacobsen SJ, Mahoney DW, Kors JA, Redfield MM, Burnett JC Jr, Rodeheffer RJ. Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community. Circulation. 2007 Mar 27;115(12):1563-70.

2. Zimmer HG. Normalization of depressed heart function in rats by ribose. Science. 1983 Apr 1;220(4592):81-2.

3. Zimmer HG, Ibel H. Ribose accelerates the repletion of the ATP pool during recovery from reversible ischemia of the rat myocardium. J Mol Cell Cardiol. 1984 Sep;16(9):863-6.

4. Müller C, Zimmer H, Gross M, Gresser U, Brotsack I, Wehling M, Pliml W. Effect of ribose on cardiac adenine nucleotides in a donor model for heart transplantation. Eur J Med Res. 1998 Dec 16;3(12):554-8.

5. St Cyr JA, Bianco RW, Schneider JR, Mahoney JR Jr, Tveter K, Einzig S, Foker JE. Enhanced high energy phosphate recovery with ribose infusion after global myocardial ischemia in a canine model. J Surg Res. 1989 Feb;46(2):157-62.

6. Ward HB, St Cyr JA, Cogordan JA, Alyono D, Bianco RW, Kriett JM, Foker JE. Recovery of adenine nucleotide levels after global myocardial ischemia in dogs. Surgery. 1984 Aug;96(2):248-55.

7. Omran H, Illien S, MacCarter D, St Cyr J, Lüderitz B. D-Ribose improves diastolic function and quality of life in congestive heart failure patients: a prospective feasibility study. Eur J Heart Fail. 2003 Oct;5(5):615-9.

8. Pauly DF, Pepine CJ. D-Ribose as a supplement for cardiac energy metabolism. J Cardiovasc Pharmacol Ther. 2000 Oct;5(4):249-58.