Correlation between grip strength level and prognosis of patients with heart failure

Zhang Wenjing; Gao Yunhe; Wang Lu; Zhang Jing

doi:10.3760/j.issn.1673-4777.2024.05.007

Abstract：Objective To explore the correlation between grip strength and prognosis of patients with heart failure.Methods A total of 560 patients with heart failure in Tangshan Traditional Chinese Medicine Hospital,Hebei Province from June 2015 to June 2017 were selected.According to the tertile of grip strength,the patients were divided into three groups,group 1:grip strength＜18.9 kg(184 cases),group 2:18.9 kg≤ grip strength＜23.5 kg(188 cases),and group 3:grip strength≥23.5 kg(188 cases).The median follow-up time was 3 years.The main end points were all-cause death and heart failure rehospitalization.Kaplan-meier survival analysis was used to determine the relationship between grip strength level and endpoint events.Multivariate Cox regression was used to analyze the correlation between grip strength and prognosis of patients with heart failure.Subgroup analysis was used to explore the effect of grip strength on the outcomes of rehospitalization for heart failure in patients with different heart failure types.Locally weighted scatterplot smoothing(Lowess)curve was drawn to evaluate the relationship between grip strength and the risk of rehospitalization for heart failure.Results A total of 560 patients with heart failure were followed up for 3 years,and 28 cases(5.0％)died from any cause and 113 cases(20.2％)were rehospitalized for heart failure.There was no statistically significant difference in the incidence of all-cause death among the three groups(P=0.074),and the incidence of rehospitalization for heart failure was statistically different[25.0％(46/184),21.3％(40/188),and 14.4％(27/188)](P=0.034).Survival analysis result showed that with the increase of grip strength during follow-up,the incidence of rehospitalization for heart failure was significantly reduced(Log-rank P=0.034).Multivariate Cox regression analysis result showed that after more confounding factors were included,the risk of heart failure rehospitalization in patients with high grip strength was still significantly reduced(group 3 vs group 1,P=0.004).Subgroup analysis of different types of heart failure showed that patients with high grip strength had a significantly lower risk of heart failure rehospitalization in heart failure with reduced ejection fraction and heart failure with preserved ejection fraction(both P＜0.05).There were no significant interactions between heart failure type and grip strength group(interaction P=0.568).Lowess curve showed that grip strength,as a continuous variable,was inversely associated with the risk of heart failure rehospitalization.Conclusion In patients with heart failure,patients with high grip strength have a significantly lower risk of heart failure rehospitalization.