The grip test: a simple method for the assessment of left ventricular performance

Area of Science:

• Cardiology
• Cardiovascular Physiology

Background:

• Isometric exercise, specifically hand grip testing, is a valuable tool in assessing cardiac function.
• Left ventricular pressure dynamics during exercise can reveal subclinical cardiac dysfunction.

Purpose of the Study:

• To evaluate the utility of isometric hand grip exercise during cardiac catheterization.
• To stratify patients with mixed cardiac pathologies based on left ventricular pressure response to isometric stress.
• To correlate these functional assessments with long-term prognosis.

Main Methods:

• 37 patients with cardiac conditions underwent isometric hand grip exercise during cardiac catheterization.
• Patients were categorized into three groups based on resting and exercise-induced left ventricular end-diastolic pressure (LVEDP).
• Follow-up data, including mortality, were collected for an average of 21-34 months.

Main Results:

• Group 1 (n=14): Normal LVEDP (<12 mm Hg) at rest and during exercise; no deaths.
• Group 3 (n=12): Elevated resting LVEDP (>12 mm Hg) with further increase during exercise; 50% mortality.
• Group 2 (n=11): Normal resting LVEDP (<12 mm Hg) but elevated during exercise; 18% mortality.

Conclusions:

• The hand grip test effectively differentiates cardiac patients into prognostic groups.
• Patients with impaired left ventricular function during isometric stress (Group 2) have a poorer prognosis.
• Group 2 patients require critical evaluation and potentially more aggressive management strategies.