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Reduced calf muscle pump function is not explained by handgrip strength measurements
Atefeh Ghorbanzadeh1, Abdi Abud2, David Liedl3
1Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN.
Insights
Handgrip strength (HGS) does not correlate with calf muscle pump function (CPF). HGS is not a reliable indicator for assessing reduced CPF, suggesting distinct underlying causes.
Area of Science:
- Vascular Medicine
- Physiology
Background:
- Reduced calf muscle pump function (CPF) is a significant risk factor for venous thromboembolism and mortality.
- Understanding factors associated with CPF is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the relationship between handgrip strength (HGS) and calf muscle pump function (CPF).
- To determine if HGS can serve as a surrogate marker for assessing reduced CPF.
Main Methods:
- 115 patients underwent noninvasive venous studies, including air plethysmography to measure CPF.
- Maximum HGS was measured bilaterally using a dynamometer.
- Correlation analysis was performed between HGS and CPF measurements.
Main Results:
- Reduced CPF was observed in a significant proportion of patients (46% right leg, 58% left leg).
- Reduced HGS was prevalent (64.3% bilaterally, 20% unilaterally).
- No significant correlation was found between HGS and CPF (Spearman's rho = 0.16 right, 0.10 left).
Conclusions:
- Handgrip strength is not significantly correlated with calf muscle pump function.
- HGS measurements are not an acceptable surrogate for assessing reduced CPF.
- These findings suggest distinct pathophysiological mechanisms underlying HGS and CPF.
Objective:
Reduced calf muscle pump function (CPF) is an independent risk factor for venous thromboembolism and mortality. We aimed to evaluate the relationship between handgrip strength (HGS) and CPF.
Methods:
Patients referred to the Gonda Vascular Laboratory for noninvasive venous studies were identified and consented. Patients underwent standard venous air plethysmography protocol. CPF (ejection fraction) was measured in each lower extremity of ambulatory patients by comparing refill volume after ankle flexes and passive refill volumes. The cutoff for reduced CPF (rCPF) was defined as an ejection fraction of <45%. Maximum HGS bilaterally was obtained (three trials per hand) using a dynamometer. HGS and CPF were compared (right hand to calf, left hand to calf) and the correlation between the measures was evaluated.
Results:
115 patients (mean age, 59.2 ± 17.4 years; 67 females, mean body mass index, 30.83 ± 6.46) were consented and assessed for HGS and CPF. rCPF was observed in 53 right legs (46%) and 67 left legs (58%). CPF was reduced bilaterally in 45 (39%) and unilaterally in 30 (26%) patients. HGS was reduced bilaterally in 74 (64.3%), unilaterally in 23 (20%), and normal in 18 (15.7%) patients. Comparing each hand/calf pair, no significant correlations were seen between HGS and CPF. The Spearman's rank correlation coefficients test yielded values of 0.16 for the right side and 0.10 for the left side.
Conclusions:
There is no significant correlation between HGS and CPF, demonstrating that HGS measurements are not an acceptable surrogate for rCPF, indicating different pathophysiological mechanisms for each process.
