Hand Grip Strength Predicts Mortality and Quality of Life in Heart Failure: Insights From the Singapore Cohort of Patients With Advanced Heart Failure

Dai, Kathy Z.; Laber, Eric B.; Chen, Huaxuan; Mentz, Robert J; Malhotra, Chetna

doi:10.1016/j.cardfail.2022.11.009

Cited by 13 publications

(27 citation statements)

References 25 publications

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“…Better muscle function, that is, hand grip strength, is an indicator not only for improved quality of life but also for survival. 9,10 This study shows that S-pindolol's positive effects are not limited to a rat model of liver cancer-associated cachexia. 1 The effects in the pancreatic cancer (KPC) model are particularly encouraging, as there are extremely limited options for patients with pancreatic cancer, with survival having increased only marginally over the last decades.…”

Section: Discussionmentioning

confidence: 77%

“…Treatment of mice with 3 mg/kg/day of S‐pindolol in KPC or LLC cancer cachexia models significantly attenuated the loss of body weight and, in particular, protected lean mass and muscle weights, leading to an improved grip strength compared with placebo‐treated mice. Better muscle function, that is, hand grip strength, is an indicator not only for improved quality of life but also for survival 9,10 …”

Section: Discussionmentioning

confidence: 99%

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Effects of S‐pindolol in mouse pancreatic and lung cancer cachexia models

Springer

Jové

Lima

et al. 2023

J cachexia sarcopenia muscle

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Background It is known that S-pindolol attenuates muscle loss in animal models of cancer cachexia and sarcopenia. In cancer cachexia, it also significantly reduced mortality and improved cardiac function, which is strongly compromised in cachectic animals. Methods Here, we tested 3 mg/kg/day of S-pindolol in two murine cancer cachexia models: pancreatic cancer cachexia (KPC) and Lewis lung carcinoma (LLC). Results Treatment of mice with 3 mg/kg/day of S-pindolol in KPC or LLC cancer cachexia models significantly attenuated the loss of body weight, including lean mass and muscle weights, leading to improved grip strength compared with placebo-treated mice. In the KPC model, treated mice lost less than half of the total weight lost by placebo (À0.9 ± 1.0 vs. À2.2 ± 1.4 g for S-pindolol and placebo, respectively, P < 0.05) and around a third of the lean mass lost by tumour-bearing controls (À0.4 ± 1.0 vs. À1.5 ± 1.5 g for S-pindolol and placebo, respectively, P < 0.05), whereas loss of fat mass was similar. In the LLC model, the gastrocnemius weight was higher in sham (108 ± 16 mg) and S-pindolol tumour-bearing (94 ± 15 mg) mice than that in placebo (83 ± 12 mg), whereas the soleus weight was only significantly higher in the S-pindolol-treated group (7.9 ± 1.7 mg) than that in placebo (6.5 ± 0.9). Grip strength was significantly improved by S-pindolol treatment (110.8 ± 16.2 vs. 93.9 ± 17.1 g for S-pindolol and placebo, respectively). A higher grip strength was observed in all groups; whereas S-pindolol-treated mice improved by 32.7 ± 18.5 g, tumour-bearing mice only show minimal improvements (7.3 ± 19.4 g, P < 0.01). Conclusions S-pindolol is an important candidate for clinical development in the treatment of cancer cachexia that strongly attenuates loss of body weight and lean body mass. This was also seen in the weight of individual muscles and resulted in higher grip strength.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Effects of S‐pindolol in mouse pancreatic and lung cancer cachexia models

Springer

Jové

Lima

et al. 2023

J cachexia sarcopenia muscle

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“…Accordingly, 31 articles underwent full‐text review, and 16 of them were further excluded for the reasons listed in Figure 1. Finally, 15 studies were included in the meta‐analysis 13–27 …”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of the included studies are summarized in Table 1. Overall, 15 cohort studies involving 7350 patients with HF were included in the meta‐analysis 13–27 . These studies were published between 2009 and 2022, and performed in Japan, Mexico, the United States, China, India, Brazil, the United Kingdom, and Singapore.…”

Section: Resultsmentioning

confidence: 99%

“…Accumulating studies suggest that besides causing low physical performance and reduced cardiorespiratory fitness in older HF patients, reduced HGS in HF may also be a prognostic factor for poor survival 11,12 . However, previous studies evaluating the prognostic role of HGS in patients with HF retrieved inconsistent results 13–27 . Therefore, the aim of the study was to evaluate the association between HGS and prognosis of patients with HF by conducting a systematic review and meta‐analysis.…”

Section: Introductionmentioning

confidence: 99%

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Handgrip strength and the prognosis of patients with heart failure: A meta‐analysis

Wang

Zhu

et al. 2023

Clinical Cardiology

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BackgroundReduced muscular strength is common in patients with heart failure (HF). The aim of the systematic review and meta‐analysis was to evaluate the association between handgrip strength (HGS) and prognosis of patients with HF.HypothesisReduced HGS may be a risk factor of poor prognosis of patients with HF.MethodsRelevant observational studies with longitudinal follow‐up were obtained by a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases. A random‐effects model was used to pool the results.ResultsFifteen studies involving 7350 patients with HF were included in the meta‐analysis. Pooled results showed that HF patients with lower HGS were associated with a higher risk of mortality during follow‐up (risk ratio [RR]: 2.00, 95% confidence interval [CI]: 1.55–2.58, p < .001; I2 = 0%). Subgroup analysis showed that the association was not significantly affected by characteristics such as study country, design, mean age of the patients, HF status (stable or advanced/acute), HF type (reduced or preserved ejection fraction), follow‐up duration, and quality score (p for subgroup difference all > 0.05). Further analysis showed that per 1 kgf decrease of HGS was associated with an 8% increased risk of mortality during follow‐up (RR: 1.08, 95% CI: 1.05–1.11, p < .001; I2 = 12%). Moreover, HF patients with lower HGS were also related to a higher risk of composite outcome of HF rehospitalization or mortality (RR: 1.67, 95% CI: 1.19–2.35, p = .003; I2 = 53%).ConclusionA low HGS may be associated with poor clinical outcomes of patients with HF.

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Weak grip strength predicts higher unplanned healthcare utilization among patients with heart failure

Poco,

Finkelstein,

Sim

et al. 2023

ESC Heart Failure

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AimsFrailty increases healthcare utilization and costs for patients with heart failure but is challenging to assess in clinical settings. Hand grip strength (GS) is a single‐item measure of frailty yet lacks evidence as a potential screening tool to identify patients at risk of higher unplanned events and related healthcare costs. We examined the association of baseline and longitudinal GS measurements with healthcare utilization and costs among patients with advanced heart failure.Methods and resultsBetween July 2017 and April 2019, we enrolled 251 patients with symptoms of advanced heart failure (New York Heart Association class III or IV) in a prospective cohort study in Singapore. We measured GS at baseline and every 4 months for 2 years and linked patients' survey data with their medical and billing records. We categorized patients as having weak GS if their GS measurement was below the 5th percentile of the age‐ and gender‐specific normative GS values in Singapore. We assessed the association between baseline GS and healthcare utilization (unplanned and planned events and healthcare costs, total costs, and length of inpatient stay) over the next 2 years using regression models. We investigated the association between longitudinal 4‐monthly GS assessments and the ensuing 4 months of healthcare utilization and costs using mixed‐effects logistic and two‐part regression models. At baseline, 22.5% of patients had weak GS. Baseline and longitudinal GS measurements were significantly associated with longer length of inpatient stay, greater likelihood of unplanned events, and higher related costs. Patients with weak GS had higher odds of an unplanned event occurring by 8 percentage points [95% confidence interval (CI) (0.01, 0.14), P = 0.026], incurred longer inpatient stays by 4 days [95% CI (1.97, 6.79), P = 0.003], and additional SG$ 4792 [US$ ~ 3594, 95% CI (1894, 7689), P = 0.014] in unplanned healthcare costs over the next 4 months.ConclusionsGS is a simple tool to identify and monitor heart failure patients at risk of unplanned events, longer inpatient stays, and higher related healthcare costs. Findings support its routine use in clinical settings.

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Hand Grip Strength Predicts Mortality and Quality of Life in Heart Failure: Insights From the Singapore Cohort of Patients With Advanced Heart Failure

Cited by 13 publications

References 25 publications

Effects of S‐pindolol in mouse pancreatic and lung cancer cachexia models

Effects of S‐pindolol in mouse pancreatic and lung cancer cachexia models

Handgrip strength and the prognosis of patients with heart failure: A meta‐analysis

Weak grip strength predicts higher unplanned healthcare utilization among patients with heart failure

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