Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Original Article

Volume 7, Number 3, June 2016, pages 95-103


Cardiac Resynchronization Therapy Leads to Improvements in Handgrip Strength

Figures

Figure 1.
Figure 1. The markers of response to cardiac resynchronization therapy, at time zero (baseline) before implantation, 6 and 12 months following CRT implantation in responders (white): (A) 6-minute walk distance (6MWD); (B) peak VO2; (C) Minnesota Living With Heart Failure Questionnaire (MLWHFQ) score; (D) left ventricular end-diastolic volume (LVEDV). Differences in data from baseline to 6 and 12 months compared using one-way ANOVA with repeated measures.
Figure 2.
Figure 2. The markers of response to cardiac resynchronization therapy, at time zero (baseline) before implantation, 6 and 12 months following CRT implantation in non-responders (black). (A) 6-minute walk distance (6MWD); (B) peak VO2; (C) Minnesota Living With Heart Failure Questionnaire (MLWHFQ) score; (D) left ventricular end-diastolic volume (LVEDV). Data during follow-up compared using one-way ANOVA with repeated measures, with no significant difference.
Figure 3.
Figure 3. The peak workload (watts) measured during cardiopulmonary exercise testing in (A) responders (white) and (B) non-responders (black) at time zero (baseline) before implantation and then 6 and 12 months following CRT, compared using one-way ANOVA with repeated measures.
Figure 4.
Figure 4. Mean handgrip strength in the left (A) and right hand (B) at zero (baseline), 6 and 12 months following cardiac resynchronization therapy (responders in solid gray line and non-responders in solid black line) with standard error bars.
Figure 5.
Figure 5. Correlation between handgrip strength (right and left) and 6-minute walk distance (6MWD) in the left (A) and right (B) hands both responders and non-responders, compared using Pearson’s correlation coefficient.

Tables

Table 1. Baseline Characteristics of Responders and Non-Responders Pre-CRT Implantation
 
Responders (N = 14)Non-responders (N = 5)P value
Mean or number given in right hand column and % or SD given in left hand column. ^Comparisons between groups analyzed using two-tailed unpaired Student’s t-test unless categorical data (*) compared using Fisher’s exact test. ACE: angiotensin converting enzyme inhibitor; ARB: angiotensin receptor blocker; CRT: cardiac resynchronization therapy; ECG: electrocardiography; EF: ejection fraction; LVEDV: left ventricular end-diastolic volume; QRSd: QRS duration.
Demographics
  Age (years)68.49.871.84.20.53
  Gender (male)1393%5100%0.99*
  Handedness (right)14100%5100%0.99*
  Body mass index (kg/m2)29.63.9826.54.410.18
  Ischemic heart disease857%360%0.99*
  Hypercholesterolemia1072%480%0.99*
  Hypertension750%240%0.99*
  Chronic kidney disease429%480%0.11*
  Diabetes536%120%0.99*
ECG/echocardiography
  QRSd (ms)163.022.8155.520.90.55
  EF (%)25.68.025.88.50.44
Medications
  ACEI/ARB1393%5100%0.99*
  Beta-blocker1286%5100%0.99*
  Loop diuretic14100%5100%0.99*
  Spironolactone964%480%0.99*
Markers of response
  6MWD (m)374.0112.8337.0144.70.23
  LVEDV (mL)201.572.5159.080.80.37
  MLWHFQ44.422.952.822.70.33
  Peak VO2 (mL/kg/min)12.51.613.92.70.25
Hand grip strength (kgf)
  Left34.411.433.05.30.42
  Right35.712.531.212.20.25

 

Table 2. Markers of Response at 0 (Baseline), 6 and 12 Months Follow-Up in Responders and Non-Responders
 
Markers of responseBaseline, mean ± SD6 months, mean ± SD12 months, mean ± SDOne-way ANOVA with repeated measures P value
Baseline vs. 6 monthsBaseline vs. 12 months
LVEDV: left ventricular end-diastolic volume; MLWHFQ: Minnesota Living With Heart Failure Questionnaire; 6MWD: 6-minute walk distance.
Responders (N = 14)
  6MWD (m)374.0 ± 112.8391.0 ± 108.1418.1 ± 105.3< 0.05< 0.05
  LVEDV (mL)175.1 ± 67.2157.0 ± 77.3121.3 ± 72.0< 0.05< 0.05
  MLWHFQ/10544.4 ± 22.924.4 ± 19.124.1 ± 21.3< 0.05< 0.05
  Peak VO2 (mL/kg/min)12.5 ± 1.614.1 ± 2.714.7 ± 1.5< 0.05< 0.01
Non-responders (N = 5)
  6MWD (m)337.0 ± 144.7279.2 ± 155.5279.6 ± 113.80.34
  LVEDV (mL)159.0 ± 80.8172.4 ± 126.2145.6 ± 88.80.63
  MLWHFQ/10552.8 ± 22.737.0 ± 20.636.4 ± 26.70.31
  Peak VO2 (mL/kg/min)13.9 ± 2.711.5 ± 4.112.8 ± 3.90.21

 

Table 3. Handgrip Strength at 0 (Baseline), 6 and 12 Months Follow-Up in Responders and Non-Responders
 
Handgrip strengthBaseline, mean ± SD6 months, mean ± SD12 months, mean ± SDOne way ANOVA with repeated measures P value
Baseline vs. 6 monthsBaseline vs. 12 months
kgf: kilograms of force; SD: standard deviation.
Responders (N = 14)
  Left (kgf)34.4 ± 11.439.7 ± 10.840.3 ± 11.3< 0.01< 0.001
  Right (kgf)35.7 ± 12.539.8 ± 11.542.2 ± 11.2< 0.01< 0.001
Non-responders (N = 5)
  Left (kgf)33.0 ± 5.327.6 ± 8.925.0 ± 11.70.30
  Right (kgf)31.2 ± 12.230.8 ± 9.929.8 ± 8.10.66