It was believed at one time that atherosclerosis—clogging of the arteries—could not be reversed. We now know this is incorrect. Similarly, it was believed until recently that following a heart attack, damaged cells of the heart muscle couldn’t be regenerated, and that damage was permanent. Researchers at New York Medical College and the Universities of Udine and Trieste, Italy, have now shed new light on this issue.
As reported in the New England Journal of Medicine in 2001, the researchers microscopically examined portions of the heart muscles of 13 patients who had recently died of a heart attack. Cells were examined both in the locations of the dead tissue and in the unaffected areas. Several markers that signify cellular growth (mitosis)—key indicators of cell regeneration—were evaluated.
Their results challenge the dogma that the adult heart is a postmitotic organ, and raise the possibility that the regeneration of myocytes may contribute to the increase in muscle mass of the myocardium.
Dr. Claude Lenfant, Director of the National Heart, Lung and Blood Institute remarked, “With this landmark study, we have a new understanding of the heart that opens up the possibility of repairing heart muscle damage after a heart attack.”
Another conclusion of the researchers is that it is likely there are either stem cells or primitive stem-cell-like cells present in the human heart. This could be the mechanism that accounts for the dramatic self-regeneration of the damaged heart muscle. These cells might be able to be coaxed to migrate to the damaged area, and further assist regeneration. It is known that injury to a target organ is sensed by distant stem cells which migrate to the damaged area, undergo differentiation, and assist in structural and functional repair. This is enabled by the high degree of stem cell plasticity.
Stem Cells
When stem cells are injected into damaged myocardial tissue, regeneration is enhanced. As reported in Nature in 2001, researchers from the National Institutes of Health injected bone marrow stem cells into the contracting wall bordering the necrotic myocardial tissue (dead heart cells) of infarcted mice. Within nine days, 68% of the dead portion of the ventricle was occupied by newly-formed myocardial tissue. D-ribose Treatment
A naturally occurring substance used by the body to synthesize and rebuild energy in every cell, D-ribose is a five carbon sugar (monosaccharide)—unlike sucrose (ordinary table sugar), glucose, and fructose, which are six carbon sugars. Its use does not raise blood sugar levels as does ordinary sugar, and therefore would be appropriate for use by diabetics. In fact, ribose administered intravenously and by high-dose oral intake lowers blood sugar levels in a dose-dependent manner.
Ribose is the most basic building block of adenosine triphosphate (ATP), the principal energy source of every cell in the body, sometimes referred to as the “energy currency” of the cell. When blood flow to the heart is impeded (ischemia, a lack of oxygen to tissues), there is a substantial lowering of tissue energy due to a decrease in the level of ATP in the heart tissues. Ribose is the beginning point for the synthesis of energetic cellular components, and its availability determines the rate at which these components can be synthesized.
Many studies have shown that energy levels in the heart can be dramatically lowered by exercise or certain cardiac diseases. Depleted cardiac energy may be associated with increased cardiac stress, reduced blood flow to the periphery, fatigue, and decreased exercise tolerance. Ribose is a key nutrient for quickly restoring cardiac energy stores.
Clinical and laboratory studies on the hearts of both animals and humans have shown many positive benefits of ribose including increased ventricular function in patients with congestive heart failure; enhanced recovery of energy-carrying nucleotide levels following ischemia; increased ability to tolerate exercise in patients with stable coronary artery disease; and decreased recovery times following strenuous exercise.
Supplemental Ribose
Supplemental ribose provides many benefits to persons with congestive heart failure, cardiomyopathy, those having had a coronary artery bypass, and persons who have had a heart attack. Because ribose is so effective in boosting ATP levels within cells, its use is greatly beneficial in any instance of ischemia where the heart muscle is deprived of oxygen either by a decrease in blood flow (e.g., exercise or congestive heart failure) or cessation of blood flow that occurs during a heart attack.
Quickly Restoring ATP Levels with Ribose
Following a heart attack, damaged, blood-deprived cells have a limited window of time to regain their function before heart muscle damage occurs as the result of cell death. The delay in restoring blood—oxygen, nutrients, ATP, etc.,—to the heart muscle subsequent to a heart attack (or cardiac bypass surgery), followed by the resumption of blood flow, causes ischemia reperfusion injury. Restoration of blood flow—reperfusion—produces inflammation and oxidative damage due to oxidative stress, and is known to be the major cause of long-term heart damage. Further, during reperfusion, cells require unusually high levels of ATP to address the damage caused by ischemia-induced oxidative damage. By quickly restoring ATP levels within the cells of the heart muscle, D-ribose is a powerful tool in rejuvenating and rebuilding the heart following reperfusion in cases of heart attacks and bypass surgery, as well as any other condition where the heart is deprived of adequate blood flow. Administration of ribose has been shown to restore post-infarction heart muscle ATP to normal or near-normal levels.