title: Effects of Complementary Creatine Monohydrate and Physical Training on Inflammatory and Endothelial Dysfunction Markers Among Heart Failure Patients.
abstract: BACKGROUND
  Previous studies have reported endothelial dysfunction and inflammatory cytokine in heart failure patients (HF).
  
  
  OBJECTIVE
  The purpose of this study was to determine the effects of creatine monohydrate and exercise on inflammatory and endothelial dysfunction markers among HF patients.
  
  
  METHODS
  One hundred patients were prospectively randomized into two groups: Intervention group which received 5 grams/day creatine monohydrate and exercised for 8 weeks; and control group which did not receive any interventions. Interleukine-6 (IL-6), high sensitivity C reactive protein (hs-CRP), P-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) were measured at the start and end of the study for both groups.
  
  
  RESULTS
  In total, 100 patients including 50 controls and 50 intervention group (54% male, mean EF of 34.2 ± 10.5% and 52% male, mean EF of 35.6 ± 12.7%, respectively) were analyzed. The serum levels of hs-CRP and IL-6 increased at the end of the study in the control group compared to the baseline, (7.5 ± 1.5 mg/L vs. 6.9 ± 1.3 mg/L, P < 0.05 and 3.0 ± 0.75 ng/L vs. 2.55 ± 0.9 ng/L, P < 0.05, respectively). However, compared to the baseline, the level of both markers decreased at the end of the study in the intervention group (6.3 ± 1.6 mg/L vs.7.5 ± 1.5 mg/L, P < 0.05 and 2.1 ± 0.8 ng/L vs.2.5 ± 0.5 ng/L, P < 0.05). Also, P-selectin and ICAM-1 levels increased at the end of study (56.9 ± 1.8 ng/L vs. 51.9 ± 1.5 ng/L, P < 0.05 and 368.1 ± 25.4 µg/L vs. 353.1 ± 10.4 µg/L, P < 0.05 respectively). Inversely, the levels of these markers decreased in the intervention group, at the end of study (49.7 ± 1.9 ng/l vs. 51.4 ± 2.1 ng/l, P < 0.05 and 342.7 ± 16.5 µg/l vs. 350.4 ± 14.7 µg/l, P < 0.05, respectively). VCAM-1 level was not decreased significantly at the end of the study in the intervention group (570.5 ± 78.4 µg/L vs. 575.3 ± 86.5 µg/L, P > 0.05).
  
  
  CONCLUSIONS
  Combination of creatine monohydrate and exercise attenuated inflammation and endothelial dysfunction markers among heart failure patients.
authors.affiliation: Department of Sports Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran.
authors.forename: Farajollah
authors.initials: F
authors.lastname: Hemati
authors.affiliation: Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran.
authors.forename: Asghar
authors.initials: A
authors.lastname: Rahmani
authors.affiliation: Department of Epidemiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran.
authors.forename: Khairollah
authors.initials: K
authors.lastname: Asadollahi
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran.
authors.forename: Koroush
authors.initials: K
authors.lastname: Soleimannejad
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Khalighi
keywords: Creatine Monohydrate; Endothelial Dysfunction; Exercise; Heart Failure; Inflammatory Markers