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

Stephen G. Sawada, Stephen Lewis, Roxanne Kovacs, Samer Khouri, Irmina Gradus-Pizlo, John A. St Cyr, Harvey Feigenbaum

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 μ/kg/min) and subsequently, high (up to 50 μ/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.

Original languageEnglish (US)
Article number5
JournalCardiovascular Ultrasound
Volume7
Issue number1
DOIs
StatePublished - Feb 26 2009

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Stress Echocardiography
Ribose
Dobutamine
Placebos
Ischemia
Myocardium
Pentoses
Cardiomyopathies
Cross-Over Studies
Echocardiography
Phosphates

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of the anti-ischemic effects of D-ribose during dobutamine stress echocardiography : A pilot study. / Sawada, Stephen G.; Lewis, Stephen; Kovacs, Roxanne; Khouri, Samer; Gradus-Pizlo, Irmina; St Cyr, John A.; Feigenbaum, Harvey.

In: Cardiovascular Ultrasound, Vol. 7, No. 1, 5, 26.02.2009.

Research output: Contribution to journalArticle

Sawada, Stephen G. ; Lewis, Stephen ; Kovacs, Roxanne ; Khouri, Samer ; Gradus-Pizlo, Irmina ; St Cyr, John A. ; Feigenbaum, Harvey. / Evaluation of the anti-ischemic effects of D-ribose during dobutamine stress echocardiography : A pilot study. In: Cardiovascular Ultrasound. 2009 ; Vol. 7, No. 1.
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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 μ/kg/min) and subsequently, high (up to 50 μ/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.",
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