Muscle strength in relation to disease severity in patients with congestive heart failure

Kazuhiro P. Izawa, Satoshi Watanabe, Hitoshi Yokoyama, Koji Hiraki, Yuji Morio, Koichiro Oka, Naohiko Osada, Kazuto Omiya

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)


OBJECTIVE: Indices of exercise capacity such as peak oxygen uptake (&OV0312;O2peak) and muscle strength are important in association with reduced mortality. The present study compared differences in &OV0312;O2peak and muscle strength indices (grip strength and knee extensor and flexor muscle strength) with disease severity and investigated the relation of these variables in congestive heart failure (CHF) patients. DESIGN: The study comprised 102 patients with stable CHF (93 men, age 61.4 ± 10.2 yrs) with left ventricular ejection fraction (LVEF) <40% by echocardiography. We used New York Heart Association (NYHA) functional class to index disease severity. &OV0312;O2peak, grip strength, knee extensor, and flexor muscle strength were determined. Patients were divided into three groups by NYHA class: class I (n = 39), class II (n = 49), and class III (n = 14). RESULTS: Age, sex, and LVEF did not differ according to NYHA class. &OV0312;O2peak and all muscle strength indices decreased with increases in NYHA class (P < 0.05). &OV0312;O2peak correlated positively with all muscle strengths (P < 0.05). Stepwise linear regression analysis revealed that grip and knee extensor strength were important in predicting &OV0312;O2peak. CONCLUSIONS: Exercise capacity and disease severity in CHF patients may be influenced not only by lower-limb but also upper-limb muscle strength.

Original languageEnglish
Pages (from-to)893-900
Number of pages8
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number11
Publication statusPublished - 2007 Nov


  • Congestive Heart Failure
  • Grip Strength
  • Knee Extension and Flexion Muscle Strength
  • New York Heart Association Classification
  • V̇O

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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