Effects of posture and venous insufficiency on endothelial-dependent and -independent cutaneous vasodilation in the perimalleolar region

Abstract

Upright posture impairs cutaneous endothelial-dependent vasodilation in the gaiter area of patients with ISVI. This may be of clinical and prognostic utility in identifying which patients with uncomplicated ISVI are at highest risk of tissue breakdown and ulcer formation in the gaiter area.

Impaired microvascular endothelial function is restored by acute lower-limb exercise in post-surgical varicose vein patients

“…2 upper panel). This finding is consistent with previous reports that microvascular endothelial function in the standing position is relatively depressed in patients with isolated superficial venous insufficiency compared to healthy age-matched controls (Klonizakis et al, 2003), and that venous surgery has no effect on microvascular endothelial function (Klonizakis et al, 2006). Vascular integrity in the healthy endothelium is maintained through the release of a variety of paracrine factors, such as NO.…”

“…Despite these benefits, the recurrence rates for varicose veins (20.7% over an 11 yr period; Winterborn et al, 2004) and venous ulcers (18% over a 5 yr period; Nelzen and Fransson, 2007) remain relatively high. The latter might be explained, at least in part, by microvascular endothelial dysfunction that persists following surgery (Klonizakis et al, 2003;Klonizakis et al, 2006). Therefore, it appears important to identify strategies to improve microvascular endothelial function in this population.…”

“…A secondary aim was to investigate whether any impairment of function can be alleviated by acute lower-limb exercise. In view of the existing literature (Klonizakis et al, 2003;Klonizakis et al, 2006), we hypothesised that, before acute exercise, microvascular endothelial function would be relatively depressed in patients compared to controls. Secondly, that any baseline impairment of microvascular endothelial vasodilator function would be attenuated by acute lower-limb exercise.…”

Effects of upper-limb exercise on lower-limb cutaneous microvascular function in post-surgical varicose-vein patients

“…A key finding was that varicosevein patients had microvascular endothelial dysfunction (reduced ACh-responsiveness) compared to age-matched healthy controls (Klonizakis et al 2003), which persisted after venous surgery . Therefore, it appears important to identify strategies to improve cutaneous microvascular endothelial function in post-surgical varicose-vein patients.…”

“…In recent years, we studied lower-limb cutaneous microvascular function in patients being treated for lower-limb varicosities (Klonizakis et al 2003) using laser Doppler flowmetry combined with incremental-dose iontophoretic administration of endothelial-dependent (acetylcholine [ACh]) and -independent (sodium nitroprusside [SNP]) vasodilators. A key finding was that varicosevein patients had microvascular endothelial dysfunction (reduced ACh-responsiveness) compared to age-matched healthy controls (Klonizakis et al 2003), which persisted after venous surgery .…”