Evaluation of the anti-ischemic effects of D-ribose during dobutamine stress echocardiography: a pilot study.

Abstract

D-Ribose, a pentose sugar, has shown to improve myocardial high-energy phosphate stores depleted by ischemia. This study investigated the ability of D-Ribose with low dose dobutamine to improve the contractile response of viable myocardium to dobutamine and to assess the efficacy of D-ribose in reducing stress-induced ischemia. Twenty-six patients with ischemic cardiomyopathy completed a two-day, randomized, double blind crossover trial comparing the effects of D-Ribose and placebo on regional wall motion. On the first study day, either D-Ribose or placebo was infused for 4.5 hours. Low (5 and 10 micro/kg/min) and subsequently, high (up to 50 micro/kg/min) dose dobutamine echocardiography was then performed. On the second study day, patients crossed over to the alternative article for a similar 4.5 hours infusion time period and underwent a similar evaluation. The wall motion response during low dose dobutamine was the same with D-Ribose and placebo in 77% of segments (203/263, Kappa = 0.37). In segments with discordant responses, more segments improved with D-Ribose than with placebo (41 vs. 19 segments, p = 0.006). With high dose dobutamine infusion, the wall motion response (ischemia vs. no ischemia) was the same with D-Ribose and placebo in 83% of interpretable segments (301/363, kappa = 0.244). In segments with discordant responses, there were more ischemic segments with placebo compared to D-Ribose (36 vs. 26, p = 0.253). Nineteen patients developed ischemia during the dobutamine and placebo infusion and 13 patients had ischemia during dobutamine and D-ribose infusion (p = 0.109). D-Ribose improved contractile responses to dobutamine in viable myocardium with resting dysfunction but had no significant effect in reducing the frequency of stress-induced wall motion abnormalities.

• Authors: Stephen G Sawada, Stephen Lewis, Roxanne Kovacs, Samer Khouri, Irmina Gradus-Pizlo, John A St Cyr, Harvey Feigenbaum
• Journal: Cardiovascular ultrasound (Cardiovasc Ultrasound) Vol. 7 Pg. 5 (Feb 07 2009) ISSN: 1476-7120 [Electronic] England
• PMID: 19200398 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Cardiotonic Agents
• Placebos
• Dobutamine
• Ribose

Topics

• Adult
• Aged
• Cardiotonic Agents (administration & dosage)
• Cross-Over Studies
• Dobutamine (administration & dosage)
• Drug Synergism
• Echocardiography
• Exercise Test
• Female
• Humans
• Male
• Middle Aged
• Myocardial Contraction (drug effects)
• Myocardial Ischemia (diagnostic imaging, drug therapy, physiopathology)
• Pilot Projects
• Placebos
• Ribose (administration & dosage)