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  2. Keyword: Hand Strength
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Original Article

Handgrip Strength in Heart Failure: Developing a Reference Equation

Suena Medeiros Parahiba et al. Édina Caroline Ternus Ribeiro Ingrid da Silveira Knobloch Débowra Dapper … Ingrid Dalira Schweigert Perry Nadine Oliveira Clausell Vivian Luft Gabriela Corrêa Souza Eneida Rejane Rabelo-Silva

Abstract

Background:

Handgrip strength (HGS) is a key indicator of overall muscle strength and functional capacity in patients with heart failure (HF). However, no reference equations specific to this population have been previously published.

Objectives:

This study aimed to develop and validate a reference equation for predicting HGS in patients with HF.

Methods:

A cross-sectional study was conducted on patients with stable HF, aged 18–79 years, diagnosed for at least three months. Maximum HGS value was obtained from three consecutive measurements. Clinical data and anthropometric assessments were collected. The sample was randomly divided into two-thirds (n=174) for derivation and one third (n=100) for validation. A multivariate regression model was applied to develop the predictive equation, including variables with a p-value < 0.25 as determined by the Wald test.

Results:

Derivation and validation samples showed no significant differences at baseline. Patients were predominantly male, older adults, and white. The derived equation was: Predicted HGS = −39.732 + (10.771 * gender [female = 0; male = 1]) – (0.158 * age [years]) + (35.096 * height [m]) + (0.448 * calf circumference [cm]) – (4.224 * the New York Heart Association class [I /II = 0; III/IV = 1]). When applied to the validation sample, the equation underestimated actual HGS by 0.68 ± 8.93 Kg.

Conclusion:

Age, sex, height, calf circumference, and NYHA class were key determinants of HGS in HF patients. The derived equation showed good predictive accuracy and may serve as a useful reference for interpreting grip strength in this population.

  • Hand Strength
  • Heart Failure
  • Reference Values
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Creative Commons Attribution (CC BY) Creative Commons license
01/12/2025 DOI: 10.36660/abc.20240777i Views 1
ABC
Editorial

A Step Forward in the Assessment of Handgrip Strength in Heart Failure

Evandro José Cesarino et al. Marildes Luiza de Castro Regina Célia Garcia de Andrade Carolina Baraldi Araujo Restini

Significance of Handgrip Strength in HF

HGS is a simple, non-invasive measure of muscle strength, correlating with physical condition and considered a prognostic marker in HF., A systematic review of 7,350 HF patients revealed that a 1 kg reduction in HGS increases mortality risk by 8% (RR 1.08, 95% CI 1.05–1.11). Unlike complex measures, such as cardiopulmonary exercise testing, HGS is low-cost, accessible, and feasible in all clinical settings, making it a straightforward tool to assess frailty and guide rehabilitation., However, existing HGS reference equations are mainly derived from healthy populations, failing to account for HF-specific factors, such as reduced cardiac output (CO) and muscle atrophy, leading to inaccurate conclusions. The manuscript’s development of an HF-specific HGS equation represents a timely advance.

[…]

  • Diastolic Heart Failure
  • Hand Strength
  • Heart Failure
  • Reference Values
  • Systolic Heart Failure
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Creative Commons Attribution (CC BY) Creative Commons license
14/11/2025 DOI: 10.36660/abc.20250579i Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Parahiba SM, Ribeiro CT, Knobloch IS, Dapper D, Perry IDS, Clausell NO, Luft V, et al. Handgrip Strength in Heart Failure: Developing a Reference Equation. Arquivos Brasileiros de Cardiologia 2025;122(9):e20240777.

Electronic Document Format (ABNT)

Parahiba, Suena Medeiros; Ribeiro, Édina Caroline Ternus; Knobloch, Ingrid da Silveira; Dapper, Débowra; Perry, Ingrid Dalira Schweigert; Clausell, Nadine Oliveira; Luft, Vivian; Souza, Gabriela Corrêa; Rabelo-Silva, Eneida Rejane. Handgrip Strength in Heart Failure: Developing a Reference Equation. Arquivos Brasileiros de Cardiologia, v. 122, n. 9, e20240777, Nov. 2025.

Electronic Document Format (APA)

Parahiba, S. M., Ribeiro, C. T., Knobloch, I. S., Dapper, D., Perry, I. D. S., Clausell, N. O., Luft, V., Souza, G. C., & Rabelo-Silva, E. R. (2025). Handgrip Strength in Heart Failure: Developing a Reference Equation. Arquivos Brasileiros de Cardiologia, 122(9), e20240777.

Electronic Document Format (ISO)

Parahiba, Suena Medeiros and Ribeiro, Édina Caroline Ternus and Knobloch, Ingrid da Silveira and Dapper, Débowra and Perry, Ingrid Dalira Schweigert and Clausell, Nadine Oliveira and Luft, Vivian and Souza, Gabriela Corrêa and Rabelo-Silva, Eneida Rejane. Handgrip Strength in Heart Failure: Developing a Reference Equation. Arquivos Brasileiros de Cardiologia [online]. 2025, vol. 122, n. 9, [cited 2026-10-14], e20240777. Available from: <https://journals.cardiol.br/en/article/handgrip-strength-in-heart-failure-developing-a-reference-equation/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Cesarino EJ, Castro ML, Andrade RCG, Restini CBA. A Step Forward in the Assessment of Handgrip Strength in Heart Failure. Arquivos Brasileiros de Cardiologia 2025;122(9):e20250579.

Electronic Document Format (ABNT)

Cesarino, Evandro José; Castro, Marildes Luiza de; Andrade, Regina Célia Garcia de; Restini, Carolina Baraldi Araujo. A Step Forward in the Assessment of Handgrip Strength in Heart Failure. Arquivos Brasileiros de Cardiologia, v. 122, n. 9, e20250579, Nov. 2025.

Electronic Document Format (APA)

Cesarino, E. J., Castro, M. L. , Andrade, R. C. G. , & Restini, C. B. A. (2025). A Step Forward in the Assessment of Handgrip Strength in Heart Failure. Arquivos Brasileiros de Cardiologia, 122(9), e20250579.

Electronic Document Format (ISO)

Cesarino, Evandro José and Castro, Marildes Luiza de and Andrade, Regina Célia Garcia de and Restini, Carolina Baraldi Araujo. A Step Forward in the Assessment of Handgrip Strength in Heart Failure. Arquivos Brasileiros de Cardiologia [online]. 2025, vol. 122, n. 9, [cited 2026-10-14], e20250579. Available from: <https://journals.cardiol.br/en/article/a-step-forward-in-the-assessment-of-handgrip-strength-in-heart-failure/>. ISSN 0066-782X

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