Decreased Hand-Grip Strength in Adolescents and Adults with Congenital Heart Disease Depending on Cyanosis

Objective: Hand-grip strength is known to be of independent predictive value for survival and disability in the healthy population. Previous studies have shown that patients with congenital heart disease (CHD) have decreased hand-grip and followed a general muscle weakness. This study aims to analyze hand-grip strength in a large patient group, to evaluate criteria and diagnostic subgroups, which are at risk to develop muscle weakness.

Patients and Methods: From January until September 2013, we examined 366 patients with various CHD (mean age: 30.7 ± 12.4 years, 136 females) and 115 healthy volunteers (mean age: 31.4 ± 11.5 years, 49 females). Hand-grip strength was measured with a Jamar Hydraulic Dynamometer (Model SH5001) in sitting position with adducted shoulders, 90-degree elbow-flexion and wrist in neutral position. The highest value out of two repetitions for each hand was recorded. The best result of the dominant hand was included into statistical analysis.

Results: In general, muscle strength is significantly reduced in CHD patients compared with healthy controls even after considering the significant influence of sex and age. (CHD: 37.9 ± 12.9 kg vs. control: 44.9 ± 13.5 kg). In the CHD group hand-grip strength was higher in males (p< 0.001) and increased with BMI (p = .017). Furthermore, hand-grip strength declines progressively with lower oxygen saturation at rest (p= 0.001). After considering the above mentioned variables, there were no differences within the diagnostic subgroups.

Conclusion: Adolescents and adults with CHD suffer from muscle weakness compared with healthy controls. In patients with CHD, lower oxygen saturation at rest is an independent risk factor for decreased hand-grip strength.