BACKGROUND: Previous studies have reported endothelial dysfunction and inflammatory cytokine in heart failure patients (HF). OBJECTIVES: The purpose of this study was to determine the effects of creatine monohydrate and exercise on inflammatory and endothelial dysfunction markers among HF patients. PATIENTS AND 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 versus 6.9 +/- 1.3 mg/L, p < 0.05 and 3.0 +/- 0.75 ng/L versus 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 versus 51.9 +/- 1.5 ng/L, p < 0.05 and 368.1 +/- 25.4 microg/L versus 353.1 +/- 10.4 microg/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 versus 51.4 +/- 2.1 ng/l, p < 0.05 and 342.7 +/- 16.5 microg/l versus 350.4 +/- 14.7 microg/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 microg/L versus 575.3 +/- 86.5 microg/L, p > 0.05). CONCLUSIONS: Combination of creatine monohydrate and exercise attenuated inflammation and endothelial dysfunction markers among heart failure patients.

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