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February 11, 2025 – A new study suggests that gait speed is a better predictor of cardiovascular death or worsening heart failure than muscle mass or strength in patients with stable heart failure. The research, published in ESC Heart Failure, highlights the significance of assessing locomotion function over traditional muscle strength and mass evaluations.
Study Findings
The study, conducted by Dr. Vladimir Cejka and his team at the Comprehensive Heart Failure Center at the University Hospital Würzburg in Germany, found that slower gait speed was independently associated with a higher risk of cardiovascular death or worsening heart failure. In contrast, parameters such as handgrip strength and appendicular skeletal muscle index showed no significant correlation with adverse outcomes.
Methodology
Researchers performed a prospective cohort study from 2016 to 2018, enrolling 205 adult patients with stable chronic heart failure. The median age of participants was 66 years, and 22% were women. All patients had been previously diagnosed with overtly reduced left ventricular ejection fraction (LVEF < 40%) or LVEF < 50% at enrollment.
The study assessed three key physical performance indicators:
- Gait speed (measured in meters per second)
- Maximal handgrip strength (measured in kilograms)
- Appendicular skeletal muscle index (measured in kg/m²)
Low physical performance was classified as a gait speed of 0.8 m/s or slower, low muscle strength as handgrip strength below 27 kg for men and 16 kg for women, and low muscle mass as an appendicular skeletal muscle index below 7.0 kg/m² for men and 5.5 kg/m² for women.
Over a median follow-up period of 4.7 years, researchers analyzed the incidence of cardiovascular death or worsening heart failure.
Key Takeaways
- A slower gait speed was independently linked to a higher risk of cardiovascular death or worsening heart failure (adjusted subdistribution hazard ratio per 0.1 m/s increase, 0.81; 95% CI, 0.68-0.95; P < .017).
- Handgrip strength and appendicular skeletal muscle index did not show significant associations with primary outcomes.
- The results remained consistent across clinical subgroups categorized by gender, comorbidities, and biomarkers.
Clinical Implications
The study authors emphasized the importance of gait speed assessment in evaluating cardiovascular risk in heart failure patients. “A differentiated analysis of multiple muscle parameters within a single cohort can provide useful evidence to identify which are clinically most important,” they wrote. “Evaluating muscular function with respect to locomotion for the risk assessment of adverse cardiovascular outcomes seems more important than the evaluation of muscle strength and mass.”
Limitations and Considerations
The researchers noted some limitations in their study:
- The study exclusively included Caucasian participants with predominantly reduced LVEF, limiting its applicability to other ethnic groups and patients with preserved ejection fraction.
- The findings were confined to the assessed muscle parameters, and other physical performance and muscle strength evaluations were not included.
Disclosures
The study authors reported no conflicts of interest.
Disclaimer
This article summarizes a scientific study and is for informational purposes only. It does not constitute medical advice. Patients should consult healthcare professionals for diagnosis and treatment of heart failure or other medical conditions.
