Varicose Veins: A Local or Systemic Hemodynamic Disorder?

Каlinin, R.E.; Suchkov, I.А.; Laut, Marina V.; Mzhavanadze, N.D.; Shanaev, I.N.

doi:10.1177/8756479320912683

Cited by 2 publications

(5 citation statements)

References 19 publications

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“…9 The venous wall in subjects with advanced CVD undergoes profound structural changes. 1 We fully agree with the LTE authors that one of the most important pathogenetic mechanisms of varicose veins is overproduction of vasoactive regulators of transcapillary metabolism and their excessive intake into the venous wall in response to impaired venous hemodynamics, which causes the ultrastructural changes in the extracellular matrix in the vessel wall and myocardium. 9 However, we consider that venous wall remodeling is caused by both hemodynamic and biochemical factors.…”

Section: Dear Editor and Colleaguessupporting

confidence: 86%

“…We found no myocardial hypertrophy in patients with varicose veins and observed no manifestations of pulmonary hypertension, while patients with post-thrombotic disease may present with myocardial hypertrophy and clinical symptoms of pulmonary hypertension 7,8 ; final results of these studies are currently being prepared for publication.…”

Section: Dear Editor and Colleaguesmentioning

confidence: 75%

“…The main patterns of the chronic venous disease (CVD) are lower extremity varicose veins and post-thrombotic disease, which are both associated with impaired venous outflow due to the phenomenon of increased venous resistance. 1 In the first case, such a condition is caused by dilated veins. The physics of venous resistance is mainly explained by the amount of blood returning to the heart, which in turn is the basis for the minute volume of the heart.…”

Section: Dear Editor and Colleaguesmentioning

confidence: 99%

“…We have read the article published by Kalinin et al 1 with great interest and enthusiasm. Briefly, they have included 583 patients and studied duplex sonography.…”

mentioning

confidence: 99%

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Varicose Veins: Systemic Hemodynamic Disorder or Systemic Vascular Wall Pathology?

Atmaca¹,

Çuğlan²,

Aksoy³

et al. 2021

Journal of Diagnostic Medical Sonography

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Dear Editor,We have read the article published by Kalinin et al 1 with great interest and enthusiasm. Briefly, they have included 583 patients and studied duplex sonography. They have also assessed diastolic function in 46 out of 583 patients by echocardiography. Statistically significant differences in the diameter of the great saphenous vein, diameter of the perforator veins (PVs), and the velocity reflux flow through the PVs have been reported between class C2 and C4 varicose veins. Engrossingly, they have also assessed diastolic dysfunction in patients with chronic venous insufficiency (CVI). They have reported that higher clinical classes of varicose disease are associated with an increased incidence of nonrestrictive blood flow through the tricuspid valve, which might be associated with a decreased inflow into the right heart in subjects with advanced CVI. No restrictive filling patterns have been identified in patients with varicose disease. Importantly, they have noted an increase in right heart chambers and right ventricular thickness. We would like to add further comments on the echocardiographic findings of patients. Echocardiographic examination of 46 out of 583 patients might have been a selection bias. Chest discomfort as an indication for echocardiography might have resulted in selecting patients who have diastolic dysfunction. Although the authors excluded the patients with pulmonary hypertension, in the presence of increased right heart chambers in association with increased right ventricular wall thickness and normal systolic functions of right and left ventricle, someone might expect to see either pulmonary hypertension or a volume load in right ventricle which contradicts the decreased inflow theory into the right heart. Comparison of diastolic filling pattern in patients with and without CVI would certainly improve our understanding of the association between CVI and the heart. We agree with the authors that the pathophysiology of varicose vein may affect the hemodynamics of the heart or diastolic filling patterns. However, this effect may come not only from hemodynamic changes but also from the ultrastructural changes in extracellular matrix tissue in vessel wall and myocardial tissue as well. In this context, we have already defined peripheral varicose vein as a local manifestation of systemic vessel wall abnormality. 2 Accordingly, we have classified peripheral varicose vein, varicocele, pelvic congestion syndrome, and hemorrhoids under the term of "dilating venous disease" 3,4 . Further studies evaluating the diastolic filling patterns of heart in patients with and without CVI would help us to include heart as an integral part of "varicose disease" or "dilating vascular diseases."

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Section: Dear Editor and Colleaguessupporting

confidence: 86%

Section: Dear Editor and Colleaguesmentioning

confidence: 75%

Section: Dear Editor and Colleaguesmentioning

confidence: 99%

“…We have read the article published by Kalinin et al 1 with great interest and enthusiasm. Briefly, they have included 583 patients and studied duplex sonography.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Varicose Veins: Systemic Hemodynamic Disorder or Systemic Vascular Wall Pathology?

Atmaca¹,

Çuğlan²,

Aksoy³

et al. 2021

Journal of Diagnostic Medical Sonography

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“…One study depicted that new cases of varicose disease are increasing among those whose professions extended standing. [ 8 9 10 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

Prevalence and awareness of varicose veins among teachers in Abha, Saudi Arabia

Dalboh

Alshehri

Alrafie

et al. 2020

J Family Med Prim Care

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Background: Teachers, compelled by the nature of their profession, are required to stand for a significant amount of time. This prolonged standing, being one of the risk factors for venous insufficiency, puts them at risk to develop varicose veins. Hence, as there is a need to educate and sensitize the teachers. This study was carried out to investigate the prevalence and awareness regarding varicose veins in school teachers. Methods: A cross sectional, questionnaire based study was carried out on 391 school teachers of the Aseer region, KSA, after obtaining ethical committee clearance and informed consent. Questions included personal, occupational, and varicose vein based questions. Responses were collected and analyzed using SPSS version 25.0 software. Frequencies and percentages were calculated. Results: Forty two percent of the teachers were found to have varicose veins most of which were females. Around 62% of the teachers suffering from varicose veins were between 36 and 45 years of age. Participants who did regular exercises were less prone to varicose than irregularly exercising participants ( P = 0.0001). No association was observed between smoking and varicose veins (odds ratio 0.15, 95% confidence interval 0.05–0.44). Conclusion: Due to high prevalence of varicose veins among teachers, it is necessary to spread awareness regarding varicose veins among them and sensitize them with the methods to prevent its formation.

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Varicose Veins: A Local or Systemic Hemodynamic Disorder?

Cited by 2 publications

References 19 publications

Varicose Veins: Systemic Hemodynamic Disorder or Systemic Vascular Wall Pathology?

Varicose Veins: Systemic Hemodynamic Disorder or Systemic Vascular Wall Pathology?

Prevalence and awareness of varicose veins among teachers in Abha, Saudi Arabia

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