Prospective association between handgrip strength and cardiac structure and function in UK adults

PLOS ONE, Nov 2019

Background Handgrip strength, a measure of muscular fitness, is associated with cardiovascular (CV) events and CV mortality but its association with cardiac structure and function is unknown. The goal of this study was to determine if handgrip strength is associated with changes in cardiac structure and function in UK adults. Methods and results Left ventricular (LV) ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), mass (M), and mass-to-volume ratio (MVR) were measured in a sample of 4,654 participants of the UK Biobank Study 6.3 ± 1 years after baseline using cardiovascular magnetic resonance (CMR). Handgrip strength was measured at baseline and at the imaging follow-up examination. We determined the association between handgrip strength at baseline as well as its change over time and each of the cardiac outcome parameters. After adjustment, higher level of handgrip strength at baseline was associated with higher LVEDV (difference per SD increase in handgrip strength: 1.3ml, 95% CI 0.1–2.4; p = 0.034), higher LVSV (1.0ml, 0.3–1.8; p = 0.006), lower LVM (-1.0g, -1.8 –-0.3; p = 0.007), and lower LVMVR (-0.013g/ml, -0.018 –-0.007; p<0.001). The association between handgrip strength and LVEDV and LVSV was strongest among younger individuals, while the association with LVM and LVMVR was strongest among older individuals. Conclusions Better handgrip strength was associated with cardiac structure and function in a pattern indicative of less cardiac hypertrophy and remodeling. These characteristics are known to be associated with a lower risk of cardiovascular events.

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Prospective association between handgrip strength and cardiac structure and function in UK adults

March Prospective association between handgrip strength and cardiac structure and function in UK adults Sebastian E. Beyer 0 1 Mihir M. Sanghvi 1 Nay Aung 1 Alice Hosking 1 Jackie A. Cooper 1 Jose Miguel Paiva 1 Aaron M. Lee 1 Kenneth Fung 1 Elena Lukaschuk 1 Valentina Carapella 1 Murray A. Mittleman 0 1 Soren Brage 1 2 Stefan K. Piechnik 1 Stefan Neubauer 1 Steffen E. Petersen 1 0 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America, 2 William Harvey Research Institute, NIHR Biomedical Research Center at Barts, Queen Mary University of London , London , United Kingdom , 3 Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford , West Wing , John Radcliffe Hospital , Headington, Oxford , United Kingdom , 4 Cardiovascular Epidemiology Research Unit, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, Massachusetts , United States of America 1 Editor: Pasquale Abete, Universita degli Studi di Napoli Federico II , ITALY 2 MRC Epidemiology Unit, University of Cambridge , Cambridge , United Kingdom - Data Availability Statement: The data in this study are owned by a third party, the UK Biobank (www. ukbiobank.ac.uk) and legal constraints do not permit public sharing of the data. The UK Biobank, however, is open to all bona fide researchers anywhere in the world. Thus, the data used in this communication can be easily and directly accessed by applying through the UK Biobank Access Management System (www.ukbiobank.ac.uk/ register-apply). Background Handgrip strength, a measure of muscular fitness, is associated with cardiovascular (CV) events and CV mortality but its association with cardiac structure and function is unknown. The goal of this study was to determine if handgrip strength is associated with changes in cardiac structure and function in UK adults. Methods and results Left ventricular (LV) ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), mass (M), and mass-to-volume ratio (MVR) were measured in a sample of 4,654 participants of the UK Biobank Study 6.3 ± 1 years after baseline using cardiovascular magnetic resonance (CMR). Handgrip strength was measured at baseline and at the imaging follow-up examination. We determined the association between handgrip strength at baseline as well as its change over time and each of the cardiac outcome parameters. After adjustment, higher level of handgrip strength at baseline was associated with higher LVEDV (difference per SD increase in handgrip strength: 1.3ml, 95% CI 0.1±2.4; p = 0.034), higher LVSV (1.0ml, 0.3±1.8; p = 0.006), lower LVM (-1.0g, -1.8 ±-0.3; p = 0.007), and lower LVMVR (-0.013g/ml, -0.018 ±-0.007; p<0.001). The association between handgrip strength and LVEDV and LVSV was strongest among younger individuals, while the association with LVM and LVMVR was strongest among older individuals. Funding: This work was supported by the following institutions: KF is supported by The Medical College of Saint Bartholomew's Hospital Trust, an independent registered charity that promotes and advances medical and dental education and research at Barts and The London School of Medicine and Dentistry. AL and SEP acknowledge support from the NIHR Cardiovascular Biomedical Research Centre at Barts and from the ªSmartHeartº EPSRC program grant (EP/P001009/ 1). SN and SKP are supported by the Oxford NIHR Biomedical Research Centre and the Oxford British Heart Foundation Centre of Research Excellence. This project was enabled through access to the MRC eMedLab Medical Bioinformatics infrastructure, supported by the Medical Research Council (grant number MR/L016311/1). The work of SB was funded by the Medical Research Council (MC_UU_12015/3). NA is supported by a Wellcome Trust Research Training Fellowship (203553/Z/Z). The authors SEP, SN and SKP acknowledge the British Heart Foundation (BHF) for funding the manual analysis to create a cardiovascular magnetic resonance imaging reference standard for the UK Biobank imaging resource in 5000 CMR scans (PG/14/89/31194). Competing interests: Steffen Petersen provides consultancy to Circle Cardiovascular Imaging Inc., Calgary, Canada. The other authors declare that they have no competing interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Conclusions Better handgrip strength was associated with cardiac structure and function in a pattern indicative of less cardiac hypertrophy and remodeling. These characteristics are known to be associated with a lower risk of cardiovascular events. Introduction Cardiovascular disease (CVD) accounts for 17.3 million deaths per year worldwide and is expected to account for 23.6 million by 2030 [ 1 ]. It is, therefore, important to identify predictors of CVD incidence to be able to initiate evidence-based primary prevention among individuals a (...truncated)


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Sebastian E. Beyer, Mihir M. Sanghvi, Nay Aung, Alice Hosking, Jackie A. Cooper, José Miguel Paiva, Aaron M. Lee, Kenneth Fung, Elena Lukaschuk, Valentina Carapella, Murray A. Mittleman, Soren Brage, Stefan K. Piechnik, Stefan Neubauer, Steffen E. Petersen. Prospective association between handgrip strength and cardiac structure and function in UK adults, PLOS ONE, 2018, Volume 13, Issue 3, DOI: 10.1371/journal.pone.0193124