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

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.