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
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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)