Reduced handgrip strength as a marker of frailty predicts clinical outcomes in patients with heart failure undergoing ventricular assist device placement.
BACKGROUND
Heart failure (HF) is associated with the derangement of muscle structure and metabolism, contributing to exercise intolerance, frailty, and mortality. Reduced handgrip strength is associated with increased patient frailty and higher morbidity and mortality. We evaluated handgrip strength as a marker of muscle function and frailty for prediction of clinical outcomes after ventricular assist device (VAD) implantation in patients with advanced HF.


METHODS AND RESULTS
Handgrip strength was measured in 72 patients with advanced HF before VAD implantation (2.3 ± 4.9 days pre-VAD). We analyzed dynamics in handgrip strength, laboratory values, postoperative complications, and mortality. Handgrip strength correlated with serum albumin levels (r = 0.334, P = .004). Compared with baseline, handgrip strength increased post-VAD implantation by 18.2 ± 5.6% at 3 months (n = 29) and 45.5 ± 23.9% at 6 months (n = 27). Patients with a handgrip strength <25% of body weight had an increased risk of mortality, increased postoperative complications, and lower survival after VAD implantation.


CONCLUSION
Patients with advanced HF show impaired handgrip strength indicating a global myopathy. Handgrip strength <25% of body weight is associated with higher postoperative complication rates and increased mortality after VAD implantation. Thus, the addition of measures of skeletal muscle function underlying the frailty phenotype to traditional risk markers might have incremental prognostic value in patients undergoing evaluation for VAD placement.
['Chung|Christine J|CJ|', 'Wu|Christina|C|', 'Jones|Meaghan|M|', 'Kato|Tomoko S|TS|', 'Dam|Tien T|TT|', 'Givens|Raymond C|RC|', 'Templeton|Danielle L|DL|', 'Maurer|Mathew S|MS|', 'Naka|Yoshifumi|Y|', 'Takayama|Hiroo|H|', 'Mancini|Donna M|DM|', 'Schulze|P Christian|PC|']
D015331:Cohort Studies D005260:Female D018737:Hand Strength D006333:Heart Failure D006353:Heart-Assist Devices D006801:Humans D008297:Male D008875:Middle Aged D011183:Postoperative Complications D011237:Predictive Value of Tests D015996:Survival Rate D016896:Treatment Outcome
handgrip strength Heart failure ventricular assist device skeletal muscle