Exploring the potential of handgrip strength as a prognostic marker in acute decompensated heart failure with reduced ejection fraction: a cross-sectional study

Frailty is associated with poor outcomes in heart failure (HF). Handgrip strength (HGS) is a simple indicator of Physical frailty. We aimed to assess the prognostic value of HGS in patients under 60 years old with acute decompensated HF with reduced ejection fraction (HFrEF). In this cross-sectional study, we enrolled 125 patients with acute decompensated HFrEF. HGS was measured using a manual dynamometer. The primary outcome was in-hospital mortality. Univariate logistic regression analysis was performed to identify risk factors associated with in-hospital mortality. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of HGS for in-hospital mortality. The in-hospital mortality rate was 16%. Survivors had numerically higher, though not statistically significant, median HGS compared to non-survivors (18.8 (IQR: 13.2-25.3) kg vs. 13 (IQR: 11.4-19.5) kg; p = 0.06). HGS showed negative correlation with length of stay (rho = - 0.202, p = 0.024) and NT-proBNP levels (rho = - 0.256, p = 0.004). The area under the ROC curve for overall HGS predicting in-hospital mortality was 0.630 (p = 0.043). Lower left ventricular ejection fraction and higher NT-proBNP levels were significantly associated with increased odds of in-hospital mortality in univariate analysis. Lower handgrip strength was associated with longer hospital stay and higher NT-proBNP levels, and demonstrated a modest ability to predict in-hospital mortality. However, further research is necessary to establish standardized measurement methods and optimal prognostic thresholds before handgrip strength can be widely implemented in the management of this patient population.