Heritability of chronic venous disease

Fiebig, Andreas; Krusche, Petra; Wolf, Andreas; Krawczak, Michael; Timm, Birgitt; Nikolaus, Susanna; Frings, N.; Schreiber, Stefan

doi:10.1007/s00439-010-0812-9

Cited by 74 publications

(58 citation statements)

References 20 publications

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“…CVI can affect the superficial venous system, the deep venous system, or both. Furthermore, the venous dysfunction may be the result of a congenital or acquired disorder [2][3][4] . Reflux-induced venous hypertension can be caused by breakdown or damage to the venous valves; more recently, it is believed that the lesion and weakness of the vessel wall play a more important role in causing reflux and even in the genesis of valve disease 1,5 -7 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Efficacy of varicose vein surgery with preservation of the great safenous vein

Barros

Araújo

Virgini-Magalhães

et al. 2015

Rev. Col. Bras. Cir.

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OBJECTIVE: To evaluate the efficacy of surgical treatment of varicose veins with preservation of the great saphenous vein. METHODS: We conducted a prospective study of 15 female patients between 25 and 55 years of age with clinical, etiologic, anatomic and pathophysiologic (CEAP) classification 2, 3 and 4. The patients underwent surgical treatment of primary varicose veins with great saphenous vein (GSV) preservation. Doppler ultrasonography exams were carried out in the first and third months postoperatively. The form of clinical severity of venous disease, Venous Clinical Severity Score (VCSS) was completed before and after surgery. We excluded patients with history of deep vein thrombosis, smoking or postoperatively use of elastic stockings or phlebotonics. RESULTS: All patients had improved VCSS (p <0.001) and reduction in the diameter of the great saphenous vein (p <0.001). There was a relationship between VCSS and the GSV caliber, as well as with preoperative CEAP. There was improvement in CEAP class in nine patients when compared with the preoperative period (p <0.001). CONCLUSION: The varicose vein surgery with preservation of the great saphenous vein had beneficial effects to the GSV itself, with decreasing caliber, and to the symptoms when the vein had maximum caliber of 7.5 mm, correlating directly with the CEAP. The decrease in GSV caliber, even without complete abolition of reflux, leads to clinical improvement by decreasing the reflux volume.

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Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Efficacy of varicose vein surgery with preservation of the great safenous vein

Barros

Araújo

Virgini-Magalhães

et al. 2015

Rev. Col. Bras. Cir.

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“…Entre los factores de riesgo relacionados con esta patología se encuentran: La edad, el sexo femenino, historial familiar de venas varicosas, sedentarismo, obesidad, o antecedentes de trombosis venosa. También se asocian a la insuficiencia venosa factores medioambientales o de comportamiento como situaciones laborales que requieren que el sujeto esté prolongados periodos de tiempo de pie o sentado 5,6 . En las últimas décadas se ha realizado un esfuerzo por parte de los expertos para desarrollar una clasificación clínica bien establecida que siente las bases para un diagnóstico y tratamiento uniforme de la insuficiencia venosa crónica.…”

Section: Introductionunclassified

“…En las últimas décadas se ha realizado un esfuerzo por parte de los expertos para desarrollar una clasificación clínica bien establecida que siente las bases para un diagnóstico y tratamiento uniforme de la insuficiencia venosa crónica. Así en 1994, el informe de consenso del American Venous Forum presentó la Clasificación CEAP (Clínica, Etiológica, Anatómica y Patofisiológica) cuyos criterios se resumen en la tabla 1 3,6,7 . Para mayor información puede consultarse el documento de consenso y sus revisiones 8 .…”

Section: Introductionunclassified

Fitoterapia para el tratamiento de la insuficiencia venosa crónica. El castaño de indias

Membiela¹

2011

Rev. Int. Cienc. Podol.

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La autora declara no tener ningún tipo de interés económico o comercial. RESUMENLa insuficiencia venosa crónica es una enfermedad común asociada con un gran impacto socioeconómico y a un deterioro significativo de la calidad de vida del paciente.Actualmente, el tratamiento de referencia son las medias de compresión, sin embargo a menudo causa malestar y una baja adhesividad al tratamiento por lo que se deben tener en cuenta otras alternativas terapéuticas.Existen diversos fármacos de síntesis para el tratamiento de la insuficiencia venosa crónica. Sin embargo, debido a la cada vez mayor demanda de los pacientes de tratamientos de Fitoterapia y al elevado uso que se viene haciendo en Europa del castaño de indias para el tratamiento de esta patología, se ha considerado relevante ofrecer una pequeña revisión actualizada de los principales aspectos farmacoterapéuticos del extracto de semillas de castaña de indias, cuyo compuesto responsable de la activad farmacológica es la mezcla de saponinas triterpénicas conocida como aescina o escina. Palabras clave: insuficiencia venosa crónica; Fitoterapia; extracto de semillas de castaña de indias; aescina. ABSTRACTChronic venous insufficiency is a common disease associated with a large economic impact and a significant deterioration in the quality of life of patients.Currently, the standard treatment are compression stockings, however this often causes discomfort and a low adhesion to the treatment so other therapies should be considered.Nowadays, various synthetic drugs for the treatment of chronic venous insufficiency are available. However, due to increasing demand from patients for phythoterapy treatments and the high use that has been done in Europe of horse chestnut for treating this condition, it was considered important to provide a brief review of the main current pharmacotherapeutic aspects of the of horse chestnut seeds extract, which compound responsible for the pharmacological activity is the mixture of triterpene saponins known as aescin or escin.

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“…Epidemiological studies have demonstrated that varicose veins have a definite hereditary nature of inheritance. 1,2 In conjunction with the presence of genes conferring disease susceptibility, various risk factors, such as prolonged standing, an increased body mass index, and preganancy, increases the mean venous pressure, in the lower extremities. 3,4 Pfisterer et al in 2014 found in an experimental mouse model that an escalated venous filling pressure induces varicose-like venous remodeling.…”

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Arterialization and anomalous vein wall remodeling in varicose veins is associated with upregulated FoxC2-Dll4 pathway

Sumi

Ramegowda

Suresh

et al. 2016

Laboratory Investigation

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Varicose veins of lower extremities are a heritable common disorder. Mechanisms underlying its pathogenesis are still vague. Structural failures such as valve weakness and wall dilatation in saphenous vein result in venous retrograde flow in lower extremities of body. Reflux of blood leads to distal high venous pressure resulting in distended veins. In an earlier study, we observed a positive association between c.-512C4T FoxC2 gene polymorphism and upregulated FoxC2 expression in varicose vein specimens. FoxC2 overexpression in vitro in venous endothelial cells resulted in the elevated mRNA expression of arterial endothelial markers such as Delta-like ligand 4 (Dll4) and Hairy/enhancer-of-split related with YRPW motif protein 2 (Hey2). We hypothesized that an altered FoxC2-Dll4 signaling underlies saphenous vein wall remodeling in patients with varicose veins. Saphenous veins specimens were collected from 22 patients with varicose veins and 20 control subjects who underwent coronary artery bypass grafting. Tissues were processed for paraffin embedding and sections were immunostained for Dll4, Hey2, EphrinB2, a-SMA, Vimentin, and CD31 antigens and examined under microscope. These observations were confirmed by quantitative real-time PCR and western blot analysis. An examination of varicose vein tissue specimens by immunohistochemistry indicated an elevated expression of Notch pathway components, such as Dll4, Hey2, and EphrinB2, and smooth muscle markers, which was further confirmed by gene and protein expression analyses. We conclude that the molecular alterations in Dll4-Hey2 signaling are associated with smooth muscle cell hypertrophy and hyperplasia in varicose veins. Our observations substantiate a significant role for altered FoxC2-Dll4 signaling in structural alterations of saphenous veins in patients with varicose veins. In conjunction with the presence of genes conferring disease susceptibility, various risk factors, such as prolonged standing, an increased body mass index, and preganancy, increases the mean venous pressure, in the lower extremities. 3,4 Pfisterer et al in 2014 found in an experimental mouse model that an escalated venous filling pressure induces varicose-like venous remodeling. This process to a greater extent mimics detrimental remodeling processes observed in human varicose veins. 5 The precise molecular mechanisms underlying the pathogenesis and progression of varicose veins are unclear. We have earlier observed a significant association of FoxC2 c.-512C4T polymorphism with the presence of varicose veins in patients. FoxC2 was also upregulated at both transcript and protein levels in varicose vein tissues of patients with varicose veins. 6 In venous endothelial cells transfected with FoxC2-overexpressing mammalian vectors, the presence of putative arterial endothelial markers Delta-like ligand 4 (Dll4) and Hairy/enhancer-of-split related with YRPW motif protein 2 (Hey2) were found.

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Heritability of chronic venous disease

Cited by 74 publications

References 20 publications

Efficacy of varicose vein surgery with preservation of the great safenous vein

Efficacy of varicose vein surgery with preservation of the great safenous vein

Fitoterapia para el tratamiento de la insuficiencia venosa crónica. El castaño de indias

Arterialization and anomalous vein wall remodeling in varicose veins is associated with upregulated FoxC2-Dll4 pathway

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