Handgrip Strength in Heart Failure: Developing a Reference Equation

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.