Venous Disease: From Pathophysiology to Quality of Life

Abstract

Venous insufficiency is a multifactorial pathology that has an important impact on the quality of life of the patients. The primary factor of venous disease is an abnormal wall distensibility, which seems to be correlated with genetic factors. Facilitating factors include hormonal impregnation and prolonged hydrostatic load, particularly under conditions where the control of the sympathetic nervous system is reduced by an increase in local temperature. The resulting valvular incompetence, combined with the augmented hydrostatic load, leads to varicosis and venous stasis. The ensuing tissue hypoxia and local edema favor inflammation and infection, which ultimately favor the occurrence of ulcers. The available data on the impact of the disease suggest a relation between the physiopathological phenomena and some parameters of health-related quality of life.

Imbalance in the Synthesis of Collagen Type I and Collagen Type III in Smooth Muscle Cells Derived from Human Varicose Veins

“…Indeed, in varicose disease, the primary defect could be an exaggerated distensibility of the veins resulting in an increase in volume and a decrease in elastic recoil leading to decreased elasticity. This is probably due to the abnormal composition of the connective tissue of the venous wall [4]. …”

“…Although valvular incompetence has long been held as the primary cause of varicose veins, dilatation of the veins precedes the valvular dysfunction [1, 2, 3]. This may indicate that the primary defect leading to varicose veins resides in a dysfunction of the venous wall [4]. The resistance to stretch and the elasticity of the venous wall depend on its content in collagen and elastic fibers.…”

Thrombomodulin Promoter Mutations, Venous Thrombosis, and Varicose Veins

“…The role of heredity in the development of varicose veins of the lower limbs has been raised many times in the literature, 26,27 but no genetic risk factor had been firmly identified. Varicose veins are characterized by a disorganized state of the vessel wall structure, and blood stasis is involved in their development.…”

Synthesis of Collagen Is Dysregulated in Cultured Fibroblasts Derived From Skin of Subjects With Varicose Veins as It Is in Venous Smooth Muscle Cells

“…1 This may indicate that the primary defect leading to varicose veins resides in a dysfunction of the venous wall. 2,3 Alterations in tissue remodeling occur in varicose veins. The content of elastin, 4 laminin, 5 fibronectin, 5 and collagen 6 are modified.…”