Copyright © 1998 by the European Society of Cardiology.
The effect of dietary creatine supplementation on skeletal muscle metabolism in congestive heart failure
a Department of Cardiovascular Medicine, University Hospital, Nottingham, U.K.
b Department of Physiology and Pharmacology, University Hospital, Nottingham, U.K.
accepted August 14, 1997
Aims
To assess the effects of dietary creatine supplementation on skeletal muscle metabolism and endurance in patients with chronic heart failure.
Methods
A forearm model of muscle metabolism was used, with a cannula inserted retrogradely into an antecubital vein of the dominant forearm. Maximum voluntary contraction was measured using handgrip dynanometry. Subjects performed handgrip exercise, 5s contraction followed by 5s rest for 5min at 25%, 50%, and 75% of maximum voluntary contraction or until exhaustion. Blood was taken at rest and 0 and 2min after exercise for measurement of lactate and ammonia. After 30min the procedure was repeated with fixed workloads of 7kg, 14kg and 21kg. Patients were assigned to creatine 20g daily or matching placebo for 5 days and returned after 6 days for repeat study.
Results
Contractions (median (25th, 75th interquartiles)) until exhaustion at 75% of maximum voluntary contraction increased after creatine treatment (8 (6, 14) vs 14 (8, 17), P=0·025) with no significant placebo effect. Ammonia per contraction at 75% maximum voluntary contraction (11·6µmol/l/contraction (8·3, 15·7) vs 8·9µmol/l/contraction (5·9, 10·8), P=0·037) and lactate per contraction at 75% maximum voluntary contraction (0·32mmol/l/contraction (0·28, 0·61) vs 0.27mmol/l/contraction (0·19, 0·49), P=0·07) fell after creatine but not after placebo.
Conclusions
Creatine supplementation in chronic heart failure augments skeletal muscle endurance and attenuates the abnormal skeletal muscle metabolic response to exercise.
Key Words: chronic heart failure • creatine • phosphocreatine • skeletal muscle metabolism
f1 Correspondence: Dr R. Andrews, Department of Cardiovascular Medicine, University Hospital, Nottingham NG7 2UH, U.K.
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