Handgrip Test for Heart Function Assessment in Adults

Overseen By Rasha Hamzeh, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Calgary

Must not be taking: Inotropes, Pressors

Disqualifiers: Unable to consent, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore a new method for checking heart function using a simple handgrip test, also known as Handgrip Dynamometry or the Isometric Handgrip Test. Researchers seek to determine if squeezing a device can help assess heart health, particularly in individuals with heart failure. The study will include participants with two types of heart failure and those without heart issues for comparison. Individuals with heart failure who experience symptoms like breathlessness or fatigue during daily activities might be suitable candidates. The test is quick, taking about 20 minutes, and involves squeezing a dynamometer (a grip strength tool) while lying down. As an unphased trial, this study offers a unique opportunity to contribute to innovative heart health research.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. However, if you are on intravenous medications to support your heart function, you cannot participate in the trial.

What prior data suggests that the handgrip test is safe for assessing heart function?

Research has shown that the handgrip test is generally safe for people with heart failure, regardless of whether their heart pumps less or normally. One study found that handgrip exercises can safely assess heart health by observing the reactions of the heart and blood vessels. Another study focused on patients with normal heart function and found that exercises like the handgrip test can improve heart function and are safe.

For those whose hearts pump less, research indicates that handgrip strength can predict exercise tolerance and overall health. The test itself is not harmful but provides valuable information about heart health. While handgrip exercises can affect blood pressure, these changes are normal and not harmful during the test.

In summary, the handgrip test is a safe method to assess heart function in both types of heart failure patients. No serious side effects have been reported in these studies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Handgrip Test for assessing heart function because it offers a non-invasive and simple method to evaluate heart health. Unlike traditional imaging tests like echocardiograms, which can be costly and time-consuming, the handgrip test requires minimal equipment and can be performed quickly. This approach could make it easier to monitor heart function regularly, especially for patients with heart failure conditions like HFrEF and HFpEF, ultimately improving patient care and outcomes.

What evidence suggests that the Handgrip Test is effective for assessing heart function?

Studies have shown that handgrip strength can help predict outcomes in people with heart failure. A review of 15 studies found that weak handgrip strength links to worse outcomes, such as a higher risk of death. Research also suggests that squeezing a handgrip device can lower blood pressure in heart failure patients. This trial will assess the handgrip test's potential to improve heart function and blood flow, particularly in those with heart failure with preserved ejection fraction (HFpEF). The handgrip test could provide an easy way to check heart health and predict potential problems in heart failure patients. ^{1 2 6 7 8}

Who Is on the Research Team?

Satish R Raj, MD MSCI

Principal Investigator

University of Calgary

Are You a Good Fit for This Trial?

This trial is for adults over 18 with heart failure, as well as those without it. Participants must be able to give informed consent and not be on IV medications like inotropes or pressors that help maintain heart function.

Inclusion Criteria

I have heart failure or I do not have heart failure, depending on the study group I am in.

Exclusion Criteria

I am on IV medication to support my heart function.

I cannot or do not want to give permission for treatment.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Single Outpatient Visit

Participants undergo non-invasive cardiovascular assessments including EKG and blood pressure monitoring, followed by a handgrip test

20 minutes

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the single visit

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Handgrip Test

Trial Overview

The study tests new non-invasive methods to assess systemic circulation and left ventricular performance using a handgrip test. It involves one outpatient visit where subjects perform the grip test while monitored with EKG electrodes and blood pressure cuffs.

How Is the Trial Designed?

Group I: HFrEF Experimental Treatment 1 Intervention

patients with heart failure with reduced ejection fraction

Group II: HFpEF Experimental Treatment 1 Intervention

heart failure with preserved ejection fraction

Group III: Control Active Control 1 Intervention

healthy (no heart failure) control participants

Who Is Running the Clinical Trial?

University of Calgary

Lead Sponsor

Trials

827

Recruited

902,000+

Published Research Related to This Trial

In a study of 14 patients recovering from their first heart attack, isometric handgrip exercise revealed differing cardiac responses, indicating potential underlying heart function issues.

While some patients showed normal heart responses during exercise, others exhibited increased peripheral resistance and a smaller rise in cardiac output, suggesting that standard recovery may not fully reflect heart health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Haemodynamic effects of isometric handgrip exercise in patients convalescent from myocardial infarction. Baccelli, G., Valentini, R., Gregorini, L., et al.[2019]

In a study of 37 patients with various heart conditions, a simple hand grip test effectively categorized patients based on their left ventricular pressure responses, helping to identify those with normal heart function versus those at higher risk of complications.

Patients in Group 1, with normal left ventricular function, had no deaths during an average follow-up of 33.8 months, while Group 3, with severely impaired function, had a 50% mortality rate over a shorter follow-up of 21.4 months, highlighting the importance of the hand grip test in assessing patient prognosis and management needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The grip test: a simple method for the assessment of left ventricular performance. Vecht, RJ.[2012]

In a case study of a 70-year-old woman with functional mitral regurgitation (MR) and acute heart failure, isometric handgrip stress testing revealed a significant deterioration of MR from moderate to severe, demonstrating the test's utility in evaluating dynamic changes in MR during acute heart failure.

After stabilization and a transcatheter mitral repair, the patient's MR remained moderate, and she did not experience rehospitalization for acute heart failure, indicating that timely intervention can lead to improved outcomes in patients with functional MR.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Differential response to isometric handgrip depending on the heart failure condition in patients with functional mitral regurgitation: a case report. Hamatani, Y., Ide, Y., Watanabe, H., et al.[2023]

In a study of 35 patients with stable angina pectoris, combining isometric handgrip stress testing with longitudinal speckle-tracking strain measurements significantly improved the detection of coronary artery disease (CAD), showing an 80% sensitivity for identifying significant coronary stenosis.

After percutaneous coronary intervention (PCI), the longitudinal strain in stenotic segments improved, indicating that this method can predict the recovery of heart function post-treatment, making it a valuable tool for assessing ischemic heart conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of longitudinal speckle tracking strain in conjunction with isometric handgrip stress test for detection of ischemic myocardial segments. Ryo, K., Tanaka, H., Kaneko, A., et al.[2016]

The handgrip exercise test effectively assesses left ventricular responses in patients with ischemic heart disease, showing significant changes in left ventricular contractility and Tl defect scores, particularly in patients with reduced global ejection fraction.

This test is low-cost, safe, and suitable for a wide range of ages, making it a practical tool for evaluating heart function in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Evaluation of cardiovascular responses to handgrip tests in patients with ischemic heart disease by radionuclide method]. Morishita, T., Kawamura, Y., Muto, T., et al.[2019]

In a study of 20 patients with coronary artery disease, handgrip exercise was used to evaluate left ventricular contractile function, revealing that 8 patients had a normal increase in contractile indices with minimal changes in pressure.

After administering nitroglycerin to 12 patients with abnormal responses, 8 normalized their reaction to handgrip, indicating that this test can help identify patients with greater contractile reserve and improve assessment of heart function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[An evaluation of ventricular function in coronary artery disease patients using the isometric (handgrip) test (author's transl)]. Specchia, G., De Servi, S., Angoli, L., et al.[2013]

In a study involving normal subjects aged 20 to 63, a standardized maximal isometric handgrip test led to a significant increase in blood pressure and heart rate by about 25%, but did not negatively affect left ventricular (LV) systolic function.

The test improved LV diastolic function, indicating that isometric handgrip can be an effective exercise test to assess cardiac function, potentially enhancing the detection of mild LV dysfunction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Left ventricular diastolic and systolic function during isometric exercise: an echocardiographic study. Bryhn, M., Castenfors, J.[2019]

Citations

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Handgrip strength and the prognosis of patients with heart ...

A meta‐analysis of 15 studies showed that low handgrip strength may be associated with poor clinical outcomes, such as all‐cause mortality and a composite ...

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pmc.ncbi.nlm.nih.gov

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Comparison of haemodynamic response to muscle reflex in ...

Isometric handgrip (IHG) training reduces the blood pressure in patients with hypertension. It is unclear how IHG exercise affects the ...

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nature.com

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Exploring the potential of handgrip strength as a prognostic ...

Frailty is associated with poor outcomes in heart failure (HF). Handgrip strength (HGS) is a simple indicator of Physical frailty.

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academic.oup.com

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Isometric exercise training in patients with heart failure with ...

These findings provide promise for IET as an effective therapeutic approach for improving haemodynamics and cardiac function in patients with HFpEF.

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nature.com

nature.com/articles/s41598-024-66194-8

Reduced dynamic changes in pulmonary artery ...

This study aims to non-invasively assess PA compliance and its dynamic properties during isometric handgrip (HG) exercise in HF patients and healthy controls.

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12228533/

Maintained sympathetic reactivity but blunted pressor ...

Recent studies have reported blunted increases in blood pressure (BP) during static handgrip (SHG) in patients with heart failure with preserved ejection ...

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sciencedirect.com

sciencedirect.com/science/article/pii/S156607022500013X

The effects of isometric handgrip and post-exercise ...

This systematic review and meta-analysis was conducted to identify a 'normative' sympathetic response to isometric handgrip and post-exercise circulatory ...

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journals.humankinetics.com

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Association of Handgrip Strength With Readmission ...

This retrospective study included patients with HF and reduced ejection fraction (HFrEF) who participated in a cardiac rehabilitation program at ...