Common to patients with CHF, ischemia, and certain cardiomyopathies, there's adenosine wasting from the myocardium (instead of just high AMP/ADP and low ATP when energy deficient, they have low AMP/ADP and low ATP due to loss of adenosine). The normal salvage pathway that the heart uses is insufficient in regenerating adequate amount of the nucleotide since the base substrates are degraded and washed out of the cell. Pentose phosphate shunt/pathway is a way of generating adenosine. However, in the heart, low activity level of glucose 6 phosphate dehydrogenase and 6-phsophogluconate dehydrogenase limits production from this pathway. D ribose enters that pathway after those 2 enzymes and bypass the rate limiting reactions- allowing for generation of adenosine and recovery of AMP/ADP/ATP pool. For review, see: http://journals.sagepub.com/doi/abs/10.1054/JCPT.2000.18011

There are some small human studies that demonstrated beneficial effects of ribose supplementation and animal studies as well. Overall interesting hypothesis that still needs more data. http://onlinelibrary.wiley.com/doi/10.1016/S1388-9842(03)00060-6/full https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439313/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716264/ http://www.sciencedirect.com/science/article/pii/S0167527308007250

Hi Abdul.. Very interesting and relevant question.D Ribose is is very essential molecule for formation of ATP which is very essential for function of myocyte. Majority of failing heart like ischaemic and nonischaemic cardiomyopathy patients have depleted cellular ATP level, so theoretically D Ribose supplementation should have beneficial effect on heart failure patient. However small studies have shown it's beneficial effect in diastolic heart failure or heart failure with preserved EF rather than systolic heart failure patient. It may be because diastole is energy dependent. Studies have shown fatigue of diastolic heart failure may improve after DRibose supplementation. I think some large well designed trial is needed with this molecule in heart failure patient to know it's benefit.. Thanks

Hi Abdul.. Continuation with the discussion.. A beautiful study by Mac Carter et al published in International Journal of Cardiology in August 2008 showed that suplimentaion with D ribose in advanced heart failure with ischaemic heart disease improved all ventilatory parameters.Some suggestions are there it may improve ventilatory parameter in COPD patients also. Thanks

Hi

At the heart of low levels of glucose activity makes low AMP/ADP and low ATP due to loss of deficient we know DRLbose is an important factor for the creation of enzymes and improvment