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Review

Role of Creatine in the Heart: Health and Disease

1
Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University of Genoa, Largo Daneo 3, 16132 Genova, Italy
2
IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy
Academic Editors: Richard B. Kreider and Jeffrey R. Stout
Nutrients 2021, 13(4), 1215; https://doi.org/10.3390/nu13041215
Received: 9 March 2021 / Revised: 2 April 2021 / Accepted: 3 April 2021 / Published: 7 April 2021
(This article belongs to the Special Issue Creatine Supplementation for Health and Clinical Diseases)
Creatine is a key player in heart contraction and energy metabolism. Creatine supplementation (throughout the paper, only supplementation with creatine monohydrate will be reviewed, as this is by far the most used and best-known way of supplementing creatine) increases creatine content even in the normal heart, and it is generally safe. In heart failure, creatine and phosphocreatine decrease because of decreased expression of the creatine transporter, and because phosphocreatine degrades to prevent adenosine triphosphate (ATP) exhaustion. This causes decreased contractility reserve of the myocardium and correlates with left ventricular ejection fraction, and it is a predictor of mortality. Thus, there is a strong rationale to supplement with creatine the failing heart. Pending additional trials, creatine supplementation in heart failure may be useful given data showing its effectiveness (1) against specific parameters of heart failure, and (2) against the decrease in muscle strength and endurance of heart failure patients. In heart ischemia, the majority of trials used phosphocreatine, whose mechanism of action is mostly unrelated to changes in the ergogenic creatine-phosphocreatine system. Nevertheless, preliminary data with creatine supplementation are encouraging, and warrant additional studies. Prevention of cardiac toxicity of the chemotherapy compounds anthracyclines is a novel field where creatine supplementation may also be useful. Creatine effectiveness in this case may be because anthracyclines reduce expression of the creatine transporter, and because of the pleiotropic antioxidant properties of creatine. Moreover, creatine may also reduce concomitant muscle damage by anthracyclines. View Full-Text
Keywords: phosphocreatine; creatine transporter; supplementation; treatment; heart; heart failure; ischemia; myocardial infarction; anthracycline; cardiac toxicity phosphocreatine; creatine transporter; supplementation; treatment; heart; heart failure; ischemia; myocardial infarction; anthracycline; cardiac toxicity
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MDPI and ACS Style

Balestrino, M. Role of Creatine in the Heart: Health and Disease. Nutrients 2021, 13, 1215. https://doi.org/10.3390/nu13041215

AMA Style

Balestrino M. Role of Creatine in the Heart: Health and Disease. Nutrients. 2021; 13(4):1215. https://doi.org/10.3390/nu13041215

Chicago/Turabian Style

Balestrino, Maurizio. 2021. "Role of Creatine in the Heart: Health and Disease" Nutrients 13, no. 4: 1215. https://doi.org/10.3390/nu13041215

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