Cardiac Doppler Parameters and Progress in Clinical Manifestation of Primary Lower Extremity Varicose Veins: A Prospective Study in China.

Yukui Ma,Jia Zhang,Zhoupeng Wu,He Huang,Qingbo Feng

doi:10.3389/fsurg.2022.791598

Abstract

ObjectiveTo investigate the features of cardiac Doppler parameters in patients with primary lower extremity varicose veins in China.Materials and MethodsWe performed a prospective statistical analysis of cardiac Doppler parameters between 129 Chinese patients with varicose veins and normal controls. Furthermore, we evaluated the relationship between cardiac Doppler and the progress or severity of lower extremity varicose veins.ResultsCompared with normal controls, patients with primary varicose veins had significantly lower early mitral and tricuspid diastolic inflow and annular velocities (E- and e′-waves), significantly higher late mitral and tricuspid diastolic inflow and annular velocities (A- and a′-waves), significantly higher mitral systolic annular velocities (s′-wave), and significantly lower mitral and tricuspid E/A ratio. There was no significant association between deep venous reflux (DVR) of the lower extremities and cardiac Doppler parameters. The relationship between Clinical Etiological Anatomical Pathophysiological (CEAP) clinical class and cardiac Doppler parameters showed on that: In comparison with normal control, all cardiac Doppler parameters of C2 clinical class patients were basically unchanged, but the cardiac Doppler parameters of the C3 or higher CEAP class patients changed. Hence, we found a potential CEAP grade cut-off value (C3) linked to statistical changes in cardiac Doppler parameters.ConclusionCardiac Doppler parameters in patients with primary varicose veins could indeed be different from those of normal people, especially for C3 class or higher CEAP clinical class patients. Therefore, for those patients, pre-operative echocardiography can be used to evaluate cardiac hemodynamic changes, but large-scale clinical promotion requires further large sample studies.

Highlights

The prevalence of primary varicose veins has been reported to be as high as 60% in the adult population [1]
Valid information was available for 129 Chinese patients aged 23–80 years with primary lower extremity varicose veins
We found some difference in cardiac Doppler parameters between primary varicose vein patients and the healthy Chinese population when there was no age difference

Summary

Introduction

The prevalence of primary varicose veins has been reported to be as high as 60% in the adult population [1]. Varicose veins of lower limbs may be caused by non-functional superficial or deep venous valves, subsequent venous reflux, and rising peripheral venous pressure [2, 3]. The aetiology, pathogenesis, pathophysiology, and clinical manifestations of primary varicose veins have been extensively studied in the peripheral venous system [2, 7–10]. The relationship between varicose veins and cardiac haemodynamics is indistinct due to lack of research. The relationship between the progress or severity of primary varicose veins and cardiac haemodynamics remains unknown. We conducted a prospective investigation of the features of cardiac Doppler parameters in Chinese patients with primary varicose veins. We supposed whether there were some connexions between cardiac Doppler parameters and the severity in patients with varicose veins. We explored the relationship between cardiac Doppler haemodynamics and the progress or severity in those patients

Methods

Results

Discussion

Conclusion