The effect of dietary creatine supplementation on skeletal muscle metabolism in congestive heart failure

Andrews, R.; Greenhaff, P.; Curtis, S.; Perry, A.; Cowley, A.J.

European Heart Journal 19(4): 617-622

1998


ISSN/ISBN: 0195-668X
PMID: 9597411
DOI: 10.1053/euhj.1997.0767
Accession: 009561420

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Abstract
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, 5 s contraction followed by 5 s rest for 5 min at 25%, 50%, and 75% of maximum voluntary contraction or until exhaustion. Blood was taken at rest and 0 and 2 min after exercise for measurement of lactate and ammonia. After 30 min the procedure was repeated with fixed workloads of 7 kg, 14 kg and 21 kg. Patients were assigned to creatine 20 g 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 (11.6 mumol/l/contraction (8.3, 15.7) vs 8.9 mumol/l/ contraction (5.9, 10.8), P=0.037) and lactate per contraction at 75% maximum voluntary contraction (0.32 mmol/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.