Chronic oral ascorbic acid therapy worsens skeletal muscle metabolism in patients with chronic heart failure

Background: Chronic heart failure (CHF) is associated with abnormalities of skeletal muscle metabolism. This may be due to impaired oxygen delivery as a result of endothelial dysfunction. Aims: We postulated that ascorbic acid would improve oxygen delivery to exercising muscle and improve skeletal muscle metabolism. Methods: We studied skeletal muscle metabolism using 31P magnetic resonance spectroscopy in 39 CHF patients. Endothelial function was assessed by changes in pulse wave velocity. Subjects were randomised to receive 4g ascorbic acid daily for 4weeks in a placebo-controlled double-blind study. Results: Ascorbic acid significantly increased phosphocreatine utilization during exercise. In addition, glycolytic ATP synthesis increased in the ascorbic acid group (change in rate of ATP synthesis at 1min −0.21±0.76 with placebo, 2.06±0.60 following ascorbic acid; p