Document Detail


Ambulatory venous pressure measurements: new parameters derived from a mathematic hemodynamic model.
MedLine Citation:
PMID:  12096271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The mechanism of venous pressure decrease during exercise still remains unclear. To explore the components involved with the regulation of ambulatory venous pressure, we reinvestigated the pattern of pressure decrease during tiptoe exercise with a newly developed mathematic model.
METHODS: Seventeen healthy limbs of 16 volunteers (normal group) and 35 limbs of 33 patients with signs and symptoms of chronic venous insufficiency were studied. Seventeen limbs had superficial venous incompetence (SVI), and 18 showed deep venous incompetence with or without concomitant superficial venous reflux. All subjects were examined with ambulatory venous pressure measurements. As parameters obtained from serial phasic changes in pressure during tiptoe movements, the pressure reduction fraction per step (decreasing component) and the pressure increase per step (increasing component) were calculated with application of the mathematic hemodynamic model and assessed comparatively in the three groups with different types of reflux (normal, SVI, and deep venous incompetence group).
RESULTS: The pressure increase per step was significantly different in each of the three groups (P <.0001, with analysis of variance), whereas no apparent difference was seen in the mean pressure reduction fraction per step among the groups. With addition of the inflation of ankle cuff, the value of pressure increase in limbs with SVI was significantly reduced (P =.0004, with Wilcoxon signed rank test), although no changes were seen in the pressure reduction fraction in each group.
CONCLUSION: Our results indicate that the pressure reduction fraction, representing calf muscle pump function, is independent of the existence or site of valve incompetence. On the other hand, the pressure increase, corresponding to the degree of reflux during exercise, correlates strongly with the severity of venous insufficiency. The theoretic model can separate the two components responsible for ambulatory venous pressure changes, calf muscle pump function and venous reflux, and provide better understanding of venous hemodynamics.
Authors:
Yutaka Hosoi; Andrew Zukowski; Stavros K Kakkos; Andrew N Nicolaides
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  36     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-03     Completed Date:  2002-07-31     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  137-42     Citation Subset:  IM    
Affiliation:
Irvine Laboratory for Cardiovascular Investigation and Research, Department of Vascular Surgery, Faculty of Medicine, Imperial College of Science, Technology and Medicine, St Mary's Hospital, London, United Kingdom. yuta-tky@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure Monitoring, Ambulatory*
Extremities / blood supply*,  physiopathology*
Humans
Models, Theoretical
Reference Values
Reproducibility of Results
Statistics as Topic
Venous Insufficiency / physiopathology
Venous Pressure / physiology*
Comments/Corrections
Comment In:
J Vasc Surg. 2002 Jul;36(1):196-8   [PMID:  12096282 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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