Journal of vascular surgery. Venous and lymphatic disorders · 2025
Rapid post exercise venous refilling time is an independent contributor to chronic venous insufficiency.
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Elbenawi Hossam, Ghorbanzadeh Atefeh, Liedl David, Rooke Thom, Wennberg Paul, McBane Robert, Houghton Damon E
Аннотация
BACKGROUND: Chronic venous insufficiency (CVI) results in complications such as pain, swelling, edema, skin changes, and ulcerations of the lower extremities. Valvular incompetence and venous obstruction are well-recognized contributors to CVI. Post-exercise venous refilling time (P-EVRT), the time to refill veins after calf muscle contractions during venous plethysmography study, is an understudied contributor to CVI.
METHODS: In this cross-sectional study of 4755 patients who were evaluated with venous air plethysmography, 9510 lower limbs were categorized based on P-EVRT into two groups: rapid (<20 seconds; n = 5256) and normal (n = 4254).
RESULTS: Rapid P-EVRT was associated with higher mean CEAP scores (3.2 vs 2.5; P < .001) and a higher prevalence of active/prior ulcers (11.6 vs 4.1%; P < .001). Univariable analysis showed that age, male sex, the severity of incompetence, obstruction, calf pump function, and rapid P-EVRT were all significantly associated with active/prior ulcers. After multivariable adjustment for these significant factors, rapid P-EVRT was an independent contributor to active/prior ulcers (odds ratio, 1.44; 95% confidence interval, 1.17-1.77). Among limbs without other venous pathology by plethysmography (incompetence, obstruction, reduced calf pump function), rapid P-EVRT remained significantly associated with higher mean CEAP scores (P < .001) and a higher prevalence of venous ulcers than limbs with normal P-EVRT (5.7% vs 2.7%; P = .001).
CONCLUSIONS: In this large contemporary study using venous air plethysmography, we demonstrate that rapid P-EVRT is an important and unique venous physiologic parameter that informs our understanding of the clinical severity of CVI.
METHODS: In this cross-sectional study of 4755 patients who were evaluated with venous air plethysmography, 9510 lower limbs were categorized based on P-EVRT into two groups: rapid (<20 seconds; n = 5256) and normal (n = 4254).
RESULTS: Rapid P-EVRT was associated with higher mean CEAP scores (3.2 vs 2.5; P < .001) and a higher prevalence of active/prior ulcers (11.6 vs 4.1%; P < .001). Univariable analysis showed that age, male sex, the severity of incompetence, obstruction, calf pump function, and rapid P-EVRT were all significantly associated with active/prior ulcers. After multivariable adjustment for these significant factors, rapid P-EVRT was an independent contributor to active/prior ulcers (odds ratio, 1.44; 95% confidence interval, 1.17-1.77). Among limbs without other venous pathology by plethysmography (incompetence, obstruction, reduced calf pump function), rapid P-EVRT remained significantly associated with higher mean CEAP scores (P < .001) and a higher prevalence of venous ulcers than limbs with normal P-EVRT (5.7% vs 2.7%; P = .001).
CONCLUSIONS: In this large contemporary study using venous air plethysmography, we demonstrate that rapid P-EVRT is an important and unique venous physiologic parameter that informs our understanding of the clinical severity of CVI.