Association of Handgrip Strength With Readmission, Mortality, and Exercise Capacity in Patients With Heart Failure.

IF 1.5 4区 医学 Q4 GERIATRICS & GERONTOLOGY
Soohyung Park, Se Hyun Park, Jieun Lee, You-Jung Choi, Dong Oh Kang, Eun Jin Park, Jah Yeon Choi, Seung-Young Roh, Dae-In Lee, Jin Oh Na, Jin Won Kim, Eung Ju Kim, Seung-Woon Rha, Chang Gyu Park, Cheol Ung Choi
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Abstract

Background: Patients with heart failure (HF) experience a marked reduction in overall skeletal muscle strength and exercise capacity, which is detrimental to their prognosis. This study examined the clinical implications of handgrip strength (HGS) in patients with HF.

Methods: Overall, 173 patients (mean age, 62 years; 81.5% male) underwent cardiac rehabilitation from 2015 to 2020. Baseline HGS was measured as the average value (kg) for both hands using a handheld dynamometer. For each patient, distance walked during a 6-min walk test and metabolic equivalents were recorded. The primary outcome was the composite of readmissions for HF and all-cause death.

Results: Receiver operating characteristic curve for the primary outcome revealed 24.9 kg as the HGS cutoff point (area under curve: 0.702, 95% confidence interval [0.610, 0.794], p < .001) and multivariable Cox proportional hazard analysis revealed that lower HGS was significantly associated with a higher risk of readmission for HF or all-cause death (hazard ratio [HR] 6.44, 95% confidence interval [2.86, 14.50], p < .001). This result is mainly attributed to the increased risk of readmission for HF in this group (hazard ratio 6.75, 95% confidence interval [2.87, 15.88], p < .001). Moreover, HGS was significantly positively correlated with distance on 6-min walk test (r = .564, p < .001) and metabolic equivalents (r = .419, p < .001), and is one of the strongest predictors of each exercise capacity category.

Conclusions: As our findings suggested, HGS is an indicator of exercise capacity and a useful marker for predicting hospital readmission or all-cause death in patients with HF.

手握强度与心力衰竭患者再入院率、死亡率和运动能力的关系
背景:心力衰竭(HF)患者总体骨骼肌力量和运动能力明显下降,这对其预后不利。本研究探讨了心衰患者握力(HGS)的临床意义。方法:173例患者(平均年龄62岁;2015 - 2020年接受心脏康复治疗(男性占81.5%)。基线HGS用手持式测力仪测量为双手的平均值(kg)。记录每位患者在6分钟步行测试期间的步行距离和代谢当量。主要结局是HF再入院和全因死亡的综合结果。结果:主要结局的受试者工作特征曲线显示HGS截断点为24.9 kg(曲线下面积:0.702,95%可信区间[0.610,0.794],p < .001),多变量Cox比例风险分析显示,HGS较低与HF再入院或全因死亡的风险较高显著相关(风险比[HR] 6.44, 95%可信区间[2.86,14.50],p < .001)。这一结果主要归因于该组HF再入院风险增加(风险比6.75,95%可信区间[2.87,15.88],p < 0.001)。此外,HGS与6分钟步行测试距离(r = .564, p < .001)和代谢当量(r = .419, p < .001)呈显著正相关,是各运动能力类别的最强预测因子之一。结论:我们的研究结果表明,HGS是心衰患者运动能力的指标,也是预测心衰患者再入院或全因死亡的有用指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
105
审稿时长
>12 weeks
期刊介绍: The Journal of Aging and Physical Activity (JAPA) is a multidisciplinary journal that publishes peer-reviewed original research reports, scholarly reviews, and professional-application articles on the relationship between physical activity and the aging process. The journal encourages the submission of articles that can contribute to an understanding of (a) the impact of physical activity on physiological, psychological, and social aspects of older adults and (b) the effect of advancing age or the aging process on physical activity among older adults. In addition to publishing research reports and reviews, JAPA publishes articles that examine the development, implementation, and evaluation of physical activity programs among older adults. Articles from the biological, behavioral, and social sciences, as well as from fields such as medicine, clinical psychology, physical and recreational therapy, health, physical education, and recreation, are appropriate for the journal. Studies using animal models do not fit within our mission statement and should be submitted elsewhere.
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