Handgrip Strength Increases the Pressure in the Portal and Left Gastric Veins in Cirrhotic Patients

1.Background Handgrip strength , a core indicator of muscle function, has been confirmed to be significantly associated with the clinical prognosis of patients with liver cirrhosis. However, no studies have explored its correlation with portal venous hemodynamics. 2. Objective The purpose of the study is to examine the effects of Handgrip strength on portal vein and left gastric vein pressure, blood flow velocity and direction in patients with liver cirrhosis.

3. Method: observational study. Detection Timing: Doppler ultrasound was employed to determine the portal flow velocity and direction at baseline and during the handgrip strength test in cirrhotic patients with a history of variceal bleeding. Three days later, prior to TIPS placement, the pressures in the portal pressure and gastric vein pressure were measured both before and after handgrip strength. Furthermore, carvedilol and vasoactive drugs were discontinued three days before the study commenced. 4. Elaboration of the Research Hypothesis 4.1. Core Hypothesis The handgrip strength level in patients with liver cirrhosis is correlated with portal venous system hemodynamic indices. Specifically, enhanced handgrip strength may affect portal hypertension and the hemodynamics of varicose veins by improving systemic muscle function or circulatory status. 4.2. Speculation on potential mechanisms Association between muscle function and circulation: As a representative of systemic muscle function, increased handgrip strength may reflect an increase in cardiac output or changes in splanchnic vascular resistance, thereby influencing portal venous hemodynamics.

Study Overview

• Status: Completed
• Conditions: Handgrip Strength; Transjugular Intrahepatic Portosystemic Shunts (TIPS)
• Intervention / Treatment: Device: Handgrip strength

• Study Type: Observational
• Enrollment (Actual): 64

Contacts and Locations

Study Locations

• China
  • Henan
    • Luoyang, Henan, China, 471003
      • The First Affiliated Hospital of Henan University of Science and Technology
  • Shanxi
    • Taiyuan, Shanxi, China, 030012
      • Shanxi Provincial People's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

This observational study was performed in two centers in China (The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology [Luoyang], and Shanxi Provincial People's Hospital [Taiyuan]) . They serve as the major tertiary referral center for the management of liver cirrhosis and its complications in our country.

Description

Inclusion Criteria:

• adult patients (≥18 years of age) with cirrhosis and a history of variceal bleeding, who were preparing for TIPS creation for secondary prophylaxis against variceal bleeding

Exclusion Criteria:

• Severe congestive heart failure, or severe untreated valvular heart disease
• Moderate to severe pulmonary hypertension
• Uncontrolled systemic infection
• Lesions (e.g., cysts) or tumors in the liver parenchyma that preclude TIPS creation
• Overt hepatic encephalopathy
• Unrelieved biliary obstruction
• Child-Pugh score > 13
• Model for end-stage liver disease (MELD) score > 18
• International normalized ratio (INR) > 5
• Platelet count < 20×109/mm3
• Participants who had undergone hand or wrist surgery within the previous 3 months or were unable to hold the dynamometer with the testing hand were excluded from the study.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Portal pressure measurement group	Device: Handgrip strength; Jamar Hand Dynamometer, from Illinois, USA. Maximum handgrip strength was measured three times, with each measurement lasting 3 seconds and a 1-minute interval between tests
Doppler Ultrasound Measurement Group	Device: Handgrip strength; Jamar Hand Dynamometer, from Illinois, USA. Maximum handgrip strength was measured three times, with each measurement lasting 3 seconds and a 1-minute interval between tests

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
portal pressure	Prior to TIPS, the pressure monitoring catheter was connected to the pressure-measuring device. Subsequently, the pressures in both the portal vein and left gastric vein were measured simultaneously at baseline and during the handgrip strength test.	through study completion, an average of 5 minutes
left gastric vein pressure	Prior to TIPS, the pressure monitoring catheter was connected to the pressure-measuring device. Subsequently, the pressures in both the portal vein and left gastric vein were measured simultaneously at baseline and during the handgrip strength test.	through study completion, an average of 5 minutes
portal flow velocity		At least 72 hours after the baseline handgrip strength and during the handgrip strength phase, measurements were conducted at intervals of 15 seconds, 30 seconds, 45 seconds, and 60 seconds after the release of strength related to the handgrip Strength
Portal vein blood flow direction		At least 72 hours after the baseline handgrip strength and during the handgrip strength phase, measurements were conducted at intervals of 15 seconds, 30 seconds, 45 seconds, and 60 seconds after the release of strength related to the handgrip Strength

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Age		Baseline
Sex		Baseline
height		Baseline
weight		Baseline
Etiology of cirrhosis		Baseline
Serum albumin (g / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
alanine aminotransferase(IU / L)	Pre-TIPS baseline characteristics, date (n=32)	Baseline
aspartate aminotransferase (IU / L)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Total bilirubin (µmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Prothrombin time (second)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Fasting blood glucose (mmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
triglyceride (mmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Total cholesterol (mmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Serum creatinine (µmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Serum potassium (mmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Serum sodium (mmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Serum chloride (mmol / l)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Platelet count (× 109 / mm3)	Pre-TIPS baseline characteristics ,date (n=32)	Baseline
Esophageal varices before endoscopic treatment	The diagnosis of esophageal varices and variceal bleeding in patients is confirmed by upper gastrointestinal endoscopy.	Baseline
Collateral vessels before TIPS placement	Vascular angiography was performed prior to TIPS placement to diagnose collateral circulation. date (n=32)	Baseline
Ascites	Prior to TIPS, ascites was evaluated by ultrasound in 32 patients with liver cirrhosis.	Baseline
Prior overt hepatic encephalopathy		Baseline
Model for end-stage liver disease score	Model for end-stage liver disease score: 6-40, the higher scores mean a worse outcome.	Baseline
Child-Pugh score	Child-Pugh score: 5-15, the higher scores mean a worse outcome	Baseline
Handgrip Strength		Baseline

Collaborators and Investigators

• Sponsor: Shanxi Provincial People's Hospital
• Collaborators: The First Affiliated Hospital of Henan University of Science and Technology

Study record dates

Study Major Dates

• Study Start (Actual): December 31, 2025
• Primary Completion (Actual): April 2, 2026
• Study Completion (Actual): April 2, 2026

Study Registration Dates

• First Submitted: December 4, 2025
• First Submitted That Met QC Criteria: December 4, 2025
• First Posted (Actual): December 17, 2025

Study Record Updates

• Last Update Posted (Actual): April 6, 2026
• Last Update Submitted That Met QC Criteria: April 2, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: MZ

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

The way of sharing IPD: Sharing and email consultation will begin after December 31, 2027.

Data collection and Management: Case record forms and electronic data captures.

• IPD Sharing Time Frame: Sharing and email consultation will begin after December 31, 2027
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No