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NAD+ precursors enter cells through specific pathways and help create NAD+ through several metabolic routes: De novo synthesis pathway : The liver creates NAD+ from L-tryptophan through the kynurenine pathway Preiss-Handler pathway : This converts nicotinic acid (NA) to NAD+ NAM salvage pathway : This pathway recycles nicotinamide (NAM) back into NAD+ and serves as the main pathway for NAD+ production Gene expression data shows the salvage pathway produces 99.3% of cardiac NAD+ stores

doi: 10.1038/nrc.2016.114 15 HensleyCTWastiATDeBerardinisRJ

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