Correlation Between Relative Handgrip Strength Index as well as Chronotropic Response Index and Heart Rate Recovery Index

Abstract

Introduction: This study evaluated the relationship between relative handgrip strenght index (rHGSi) as well as chronotropic response index (Cri) and heart rate recovery index (HRRi), which are the prognostic parameters of treadmill exercise. Patients and Methods: In total, 490 patients who were recommended to undergo the exercise electrocardiographic test were recruited in this study. The participants were divided into two groups based on both Cri (normal and low CRi groups) and rHGSi (high and low rHGSi groups). Results: The treadmill exercise time, peak heart rate, and metabolic equivalents were higher in the high rHGSi group than in the low rHGSi group. In addition, the 1st minute HRRi and Cri were higher in the high rHGSi group than in the low rHGSi group. The treadmill exercise time, basal and peak heart rate, metabolic equivalents, and 1st minute HRRi were significantly lower in the low CRi group than in the normal Cri group. rHGSi was considered an independent predictor of low chronotropic response index. Based on a bivariate analysis, a statistically significant positive correlation was observed between Cri and rHGSi. Similarly, there was a positive association between rHGSi and 1st minute HRRi. Conclusion: rHGSi might be a practical and effective tool in cardiovascular risk stratification.

Keywords

• Relative handgrip strength
• heart rate recovery
• low chronotropic index

Rölatif El Kavrama Gücü İndeksi ile Kronotropik Cevap İndeksi ve Kalp Hızı Toparlanma İndeksi İlişkili mi?

Abstract

Giriş: Bu çalışmada, rölatif el kavrama gücü indeksi ile egzersiz testinin önemli prognostik belirteçleri olan kronotropik cevap indeksi ve kalp hızı toparlanma indeksi arasındaki ilişki araştırılmıştır. Hastalar ve Yöntem: Treadmill egzersiz testi planlanan 490 hasta çalışmaya alındı. Çalışma grubu el kavrama gücü indeksi ve kronotropik cevap indeksi değerlerine göre ayrı ayrı ikişer gruba ayrıldı. Bulgular: Yüksek rölatif el kavrama gücü indeksi grubunda, treadmill egzersiz zamanı, zirve kalp hızı ve metabolik ekivalan değeri düşük rölatif el kavrama gücü indeksi gruba kıyasla daha yüksek bulunmuştur. Ek olarak kronotropik cevap indeksi ve birinci dakika kalp hızı toparlanma indeksi gibi prognostik parametreler de yüksek rölatif el kavrama gücü indeksi grubunda daha yüksek bulunmuştur. Çalışma grubunu kronotropik cevap indeksine göre gruplandırıp incelediğimizde, treadmill egzersiz zamanı, bazal ve zirve kalp hızı, metabolik ekivalan ve birinci dakika ve kalp hızı toparlanma indeksi değerleri düşük kronotropik cevap indeksi grubunda yüksek kronotropik cevap indeksi gruba kıyasla daha düşük tespit edilmiştir. Ek olarak, rölatif el kavrama gücü indeksi düşük kronotropik cevap indeksinin bağımsız öngörücüsü olarak saptanmıştır. Yapılan çalışmada kronotropik cevap indeksi ve rölatif el kavrama gücü indeksi arasında pozitif korelasyon saptanmıştır. Aynı şekilde birinci dakika kalp hızı toparlanma indeksi ve rölatif el kavrama gücü indeksi arasında da istatistiksel olarak anlamlı derecede korelasyon saptanmıştır. Sonuç: Rölatif el kavrama gücü indeksi popülasyonda kardiyovasküler risk sınıflandırması için kullanışlı ve pratik bir araçtır.

Keywords

• Rölatif el kavrama gücü indeksi
• kalp hızı toparlanma indeks
• kronotropik cevap indeksi

References

1. 1. Wu SW, Wu SF, Liang HW, Wu ZT, Huang S. Measuring factors affecting grip strength in a Taiwan Chinese population and a comparison with consolidated norms. Appl Ergon 2009;40:811-5.
2. 2. Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther 2008;31:310.
3. 3. Lee WJ, Peng LN, Chiou ST, Chen LK. Relative handgrip strength is a simple indicator of cardiometabolic risk among middle-aged and older people: a nationwide population-based study in Taiwan. PLoS One 2016;11.
4. 4. Kawamoto R, Ninomiya D, Kasai Y, Kusunoki T, Ohtsuka N, Kumagi T, et al. Handgrip strength is associated with metabolic syndrome among middle-aged and elderly community dwelling persons. Clin Exp Hypertens 2016;38:245-51.
5. 5. Lauer MS, Okin PM, Larson MG, Evans JC, Levy D. Impaired heart rate response to graded exercise: prognostic implications of chronotropic incompetence in the Framingham Heart Study. Circulation 1996;93:1520-6.
6. 6. Lauer MS, Francis GS, Okin PM, Pashkow FJ, Snader CE, Marwick TH. Impaired chronotropic response to exercise stress testing as a predictor of mortality. JAMA 1999;281:524-9.
7. 7. Kligfield P. Lauer MS. Exercise electrocardiogram testing beyond the ST segment circulation. 2006;114:2070-82.
8. 8. Kannankeril PJ, Le FK, Kadish AH, Goldberger JJ. Parasympathetic effects on heart rate recovery after exercise. J Investig Med 2004;52:394-401.

9. 9. Savin WM, Davidson DM, Haskell WL. Autonomic contribution to heart rate recovery from exercise in humans. J Appl Physiol 1982;53:1572-5.
10. 10. Vivekananthan DP, Blackstone EH, Pothier CE, Lauer MS. Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of coronary disease. J Am Coll Cardiol 2003;42:831-8.
11. 11. La Rovere MT, Bigger JT Jr, Marcus FI, Mortara A, Schwartz PJ, for the ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet 1998;351:478-84.
12. 12. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC task force for the management of arterial hypertension. Blood Press 2018;27:314-40.
13. 13. Kerner W, Bruckel J. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes 2014;122:384-6.
14. 14. Griffin BP, Menon V. Exercise Electrocardiographic Testing. Chapter 45. Manual of Cardiovascular Medicine. 5th ed. New York: Wolters Kluwer, 2019:672-3.
15. 15. Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet 2015;386:266-73.
16. 16. Ortega FB, Silventoinen K, Tynelius P, Rasmussen F. Muscular strength in male adolescents and premature death: cohort study of one million participants. BMJ 2012;345.
17. 17. Lauer MS, Francis GS, Okin PM, Pashkow FJ, Snader CE, Marwick TH. Impaired chronotropic response to exercise stress testing as a predictor of mortality. JAMA 1999;281:524-9.
18. 18. Azarbal B, Hayes SW, Lewin HC, Hachamovitch R, Cohen I, Berman DS. The incremental prognostic value of percentage of heart rate reserve achieved over myocardial perfusion single-photon emission computed tomography in the prediction of cardiac death and all-cause mortality: superiority over 85% of maximal age-predicted heart rate. J Am Coll Cardiol 2004;44:423-30.
19. 19. Myers J, Tan SY, Abella J, Aleti V, Froelicher VF. Comparison of the chronotropic response to exercise and heart rate recovery in predicting cardiovascular mortality. Eur J Cardiovasc Prev Rehabil 2007;14:215-21.
20. 20. Prestes J, Tibana RA. Muscular static strength test performance and health: absolute or relative values? Rev Assoc Med Bras 2013;59:308-9.
21. 21. Silva CR, Saraiva B, Nascimento DDC. Relative handgrip strength as a simple tool to evaluate impaired heart rate recovery and a low chronotropic index in obese older women. Int J Exerc Sci 2018;11:844-55.