Key result
Prolonged FTSST predicts cardiac dysfunction better than hand grip strength in men with advanced CKD.
Why the study?
Heart failure with preserved ejection fraction contributes to sarcopenia progression, driven primarily by left ventricular diastolic dysfunction, prompting examination of how muscle strength relates to diastolic dysfunction in non-dialysis CKD.
Is decreased muscle strength associated with echocardiographic parameters of left ventricular diastolic dysfunction in men with advanced chronic kidney disease not on dialysis?
Observational (n=46)
No
Is decreased muscle strength associated with echocardiographic parameters of left ventricular diastolic dysfunction in men with advanced chronic kidney disease not on dialysis?
In men with advanced CKD not on dialysis, lower limb muscle strength assessed by FTSST is more sensitive than hand grip strength for predicting left ventricular diastolic dysfunction.
Answers are grounded in this paper and cite their sources.
Prolonged FTSST may flag LV dysfunction better than grip strength in nondialysis CKD G4-5 men; hypothesis-generating, needs prospective validation.
Background: Sarcopenia is defined by decreased muscle strength along with low muscle quantity or quality. The assessment of muscle strength may be performed by grip strength test or chair stand test (CST) and both of these tests are treated as equivalent tools for assessing muscle strength. Heart failure with preserved ejection fraction (HFpEF) contributes to the progression of sarcopenia, and it is left ventricular diastolic dysfunction (LVDd) which primarily leads to the development of HFpEF. The aim of this study was to examine the relationship of muscle strength with echocardiographic parameters of LVDd in patients with CKD and eGFR ≤ 29 mL/min/1.73 m2 not treated with dialysis. Methods: The study samples consisted of 46 men with CKD stages G4–G5 not treated with dialysis: 23 participants with HGS < 27 kg and 23 individuals with HGS ≥ 27 kg. The assessment of muscle strength was provided by the hand grip strength (HGS) test and the five-times sit-to-stand test (FTSST). Transthoracic echocardiography was performed with the use of a convex probe in conjunction with a Logiq P6 ultrasound system. Results: In G4–G5 CKD patients, upper limb muscle strength did not correspond to lower limb muscle strength. Participants with prolonged FTSST had a lower mean value of septal e’ and higher mean E/e’ compared to individuals with correct both HGS and FTSST. Participants with correct HGS and prolonged FTSST had the lowest mean left ventricular ejection fraction (LVEF), as well as the lowest mean tricuspid annular plane systolic excursion (TAPSE). Conclusions: In G4–G5 CKD patients not treated with dialysis, HGS and FTSST are not equivalent and should not be used interchangeably. In this population, decreased muscle strength is associated with LVDd and FTSST is more sensitive than HGS in the prediction of LVDd. Low muscle strength is also associated with systolic function of the left and right ventricle in G4–G5 CKD patients not treated with dialysis.
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Romejko et al. (2026) conducted an observational in Men aged 40-80 years with chronic kidney disease stages G4-G5 with eGFR ≤ 29 mL/min/1.73 m2 not treated with dialysis (n=46). Muscle strength assessment by hand grip strength (HGS) test and five-times sit-to-stand test (FTSST) vs. Comparison between patients with decreased HGS (<27 kg) and those with normal HGS (≥27 kg); and between prolonged FTSST (>15 s) and normal FTSST (≤15 s) was evaluated on Echocardiographic parameters of left ventricular diastolic dysfunction (LVDd) including septal e’, average E/e’ ratio, left ventricular ejection fraction (LVEF), and tricuspid annular plane systolic excursion (TAPSE) (p=p ranged from 0.016 to 0.030 for main LVDd parameters between groups). In men with CKD stages G4-G5 not on dialysis, prolonged FTSST (>15 s) was more strongly associated with parameters of left ventricular diastolic dysfunction and lower left and right ventricular systolic function (LVEF 52.0% vs 59.3%, p=0.021; TAPSE 20.63 mm vs 25.93 mm, p=0.017) than hand grip strength, indicating FTSST is more sensitive in predicting cardiac dysfunction in this population.
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