D-ribose aids heart failure patients with preserved ejection fraction and diastolic dysfunction: a pilot study.
D-ribose aids heart failure patients with preserved ejection fraction and diastolic dysfunction: a pilot study.
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DOI：
10.1177/1753944715572752
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发表时间：
2015-06
影响因子：
2.3
通讯作者：
Abraham WT
中科院分区：
文献类型：
--
作者：
Bayram M;St Cyr JA;Abraham WT
心力衰竭的发病率持续上升，全球每年新诊断的患者约为55万例。超过一半的心力衰竭患者保留射血分数或孤立性舒张功能不全，目前尚无有效的舒张功能不全治疗方法。每个细胞都需要足够的高能磷酸盐来维持其完整性和功能。先前的研究表明，舒张功能是能量依赖的，补充d -核糖已被证明可以改善舒张功能障碍。本研究探讨了d -核糖在保留收缩功能和舒张功能不全的充血性心力衰竭患者中可能发挥的作用。11例符合入选标准的临床症状、左室收缩功能正常、超声心动图显示舒张功能不全的纽约心脏协会II-IV级患者入组。每例患者口服d -核糖（5 g/剂），疗程6周。在基线、6周和9周（停用d -核糖后3周）进行超声心动图评估、心肺代谢测试和主观问卷评估。在64%的患者中，组织多普勒速度（E’）得到改善，并维持在9周。5例患者早期舒张充盈速度(E)与早期环舒张速度（E’）之比明显改善。在valsalva或抬腿和握力练习中，这些测量结果没有明显差异。4名患者的最大预测VO2值也有所改善；两名患者表现出恶化的效果，其余患者无差异。主观评估显示，只有一名患者获益，一名患者症状加重，其余队列无变化。这项初步研究揭示了d -核糖的一些有益趋势，即使是在这个小的队列规模。然而，未来的研究需要进一步证实这些观察到的好处。
The incidence of heart failure continues to escalate with >550,000 newly diagnosed patients annually worldwide. More than half of the patients with heart failure have preserved ejection fraction or isolated diastolic dysfunction, for which no current effective therapies for diastolic dysfunction exist. Every cell requires adequate levels of high energy phosphates to maintain integrity and function. Previous studies have demonstrated that diastolic function is energy dependent and supplemental D-ribose has shown to improve diastolic dysfunction. This study investigated what role D-ribose might play in congestive heart failure patients with preserved systolic function and diastolic dysfunction. A total of 11 patients, New York Heart Association class II–IV, with clinical symptoms, normal left ventricular systolic function and echocardiographic evidence of diastolic dysfunction were enrolled after meeting inclusion criteria. Each patient received oral D-ribose (5 g/dose) for 6 weeks. Echocardiographic evaluation, cardiopulmonary metabolic testing and subjective questionnaire assessment were performed at baseline, 6 weeks and at 9 weeks (3 weeks after discontinuing D-ribose). An improvement in their tissue Doppler velocity (E′), which was maintained at 9 weeks, was demonstrated in 64% of the patients. Five patients showed an improvement in their ratio of early diastolic filling velocity (E) to early annulus relaxation velocity (E′). There was no appreciable difference in these measurements during valsalva or with leg raising and handgrip exercises. Four patients also had an improvement in their maximum predicted VO2 values; two demonstrated a worsening effect and no differences were noted in the remaining patients. Subjective assessment revealed a benefit in only one patient, worsening symptoms in one patient and no change in the remaining cohort. This pilot study revealed some beneficial trends with D-ribose even with this small cohort size. However, future investigations are necessary to further substantiate these observed benefits.