D-Ribose Benefits Low Level Exercise in Advanced Class CHF Patients

Background: Advanced congestive heart failure (CHF) patients (pts) commonly experience dyspnea and exercise intolerance. Although drug therapy has focused on reducing symptoms in CHF patients, many pharmaceuticals, have non-metabolic mechanisms of action and fall short of demonstrating improvement in pt. exercise. Ribose (R), a natural occurring pentose carbohydrate, has previously shown its beneficial effects in replenishing high-energy phosphates and improving diastolic dysfunction following ischemia. Ribose also has reported to improve ventilation (VENT) and O2 uptake efficiency in class III-IV CHF pts. Additional VENT-based measurements at anaerobic threshold (AT) may offer a more complete assessment of exercise tolerance in CHF. Methods: The following VENT-based parameters at AT were assessed in 16 CHF pts (class III-#9, IV-#7): VO2, VT (tidal volume)/ VCO2 or VENT efficiency, and HR (heart rate) to VT coupling. Each pt. consumed 5 gms/dose of oral R, tid for 8 wks. All pts.underwent sub-max cardiopulmonary exercise testing, using a 4-minute sub-max step protocol, at baseline (pre-R) and postR. Results: All pts demonstrated a significant improvement with R at AT in VO2, VT/ VCO2, and HR/VT. Further, 7 of 16 pts (44%) demonstrated a positive Weber functional class improvement (class C to B) with R. Conclusion: Ribose demonstrated that advanced CHF pts can and do experience improvements in sub-max exercise tolerance at AT when taking R. Based upon improvements in both VO2 and VT/VCO2 at the AT, R should strongly be considered as an adjunct to standard therapeutic regimens for advanced CH.