D-Ribose in Congestive Heart Failure and Ischemic Disease

Clarence A. Johnson

• Introduction
  
• NYHA Classification of Congestive Heart Failure Severity
  
• Drug Treatments Only Slow the Progression of the Disease
  
• The Effect of Cardiac Energy on Diastolic Dysfunction
  
• The Role of Ribose in Maintaining Cardiac Energy
  
• Opportunity
  
• References
  

Introduction

Congestive heart failure (CHF) is a disease caused by weakening of the heart muscle making it unable to pump a sufficient volume of blood to supply the body's need for oxygen. Cardiovascular diseases such as hypertension, coronary artery disease and cardiomyopathy often lead to the onset of CHF causing both systolic and diastolic cardiac dysfunction. Nearly all patients with systolic dysfunction also present with some degree of diastolic dysfunction, specifically impaired relaxation and loss of ventricular compliance.

The severity of CHF is defined by New York Heart Association (NYHA) classification falling into four categories as shown in Figure 1. A recent study conducted at the Mayo Clinic, Rochester, Minnesota reported that 25% of all adults over age 45 in the U.S. exhibit mild to severe symptoms of diastolic dysfunction and CHF. However, less than half of those presenting with even moderate or severe diastolic or systolic dysfunction had recognized CHF or knew they were at risk. The authors conclude that 20% of people over age 40 are at risk for developing CHF during their lifetime and that the presence or absence of diastolic dysfunction, regardless how severe, is predictive of all-cause mortality.