Association of muscular strength with pulsatile and steady hemodynamics in patients with acute myocardial infarction.

INTRODUCTION: Handgrip strength (HG) and blood pressure (BP) are strongly interrelated. BP is an essential component of arterial load (AL), which modulates cardiac output. Objectives: We investigated the correlation between HG and both steady and pulsatile components of AL in subjects with acute myocardial infarction. PATIENTS AND METHODS: We studied 295 participants (mean age 63 years) with acute myocardial infarction. HG strength, echocardiography, local arterial stiffness, arterial tonometry, and continuous arterial pulse, beat-to-beat wave registration was performed. RESULTS: In univariable analyses, HG correlated with arterial stiffness (PWV-pulse wave velocity), ventricular-arterial coupling (VA coupling), and measures of pulsatile arterial load: aortic characteristic impedance (Zao), total arterial compliance (TAC) and central fractional arterial pulse pressure (cFPP). In a multivariable model including age, HG, body mass index, systolic blood pressure or sex and descriptors of pulsatile load, Zao remained associated with HG (R2=58 for the model, P<0.001) similarly TAC (R2=23% for the model, P<0.001) and cFPP (R2=20% for the model, P<0.001). In the model, including sex, only Zao remained significantly associated with HG (R2=67%, for the model). Comparisons between men and women of the adjusted mean value demonstrated that Zao and cFPP were considerably higher in females (P<0.001 and P=0.02, respectively). At the same time, TAC was lower in this population (P<0.001). CONCLUSIONS: In a cohort of subjects with acute myocardial infarction handgrip correlated independently and significantly with descriptors of the pulsatile arterial load. The role of sex in this interrelations needs further study.