Patients with Incompetent Valves in Chronic Venous Insufficiency Show Increased Systematic Lipid Peroxidation and Cellular Oxidative Stress Markers.

Miguel A Ortega,Julia Buján,María J Álavrez-Rocha,Felipe Sainz,Natalio García-Honduvilla,Melchor Álavrez-Mon,Mayte Sola,Beatriz Romero,Ángel Asúnsolo

doi:10.1155/2019/5164576

Abstract

Chronic venous insufficiency (CVI) is a disease that impacts cellular homeostasis. CVI may occur with a valvular destruction process known as venous reflux or valvular incompetence. One of the cellular processes that may be triggered as a consequence of these events is the production of reactive oxygen species (ROS), which may trigger the production of different cellular markers and cell damage processes, such as lipid peroxidation. Therefore, the present study performed an observational, analytical, and prospective cohort study by reviewing 110 patients with CVI, and the activities and plasma levels of iNOS, eNOS, NOX1, and NOX2 were determined using immunohistochemistry and RT-qPCR. Lipid peroxidation (MDA) was also measured. Patients were distributed according to the presence or absence of valvular incompetence-venous reflux, which was diagnosed clinically as the absence of venous reflux (NR = 29) or presence of venous reflux (R = 81). Each group was divided according to age, with a cutoff point of fifty years (NR < 50 = 13, NR ≥ 50 = 16, R < 50 = 32, and R ≥ 50 = 49). The results showed that R patients exhibited significantly increased plasma MDA levels, and R < 50 patients exhibited the highest statistically significant increase. iNOS, NOX1, and NOX2 exhibited the highest gene and protein expression in R patients. The increased expression was maintained in the R < 50 patients. Our data suggest that young patients with valvular incompetence (venous reflux) show higher levels of lipid peroxidation and oxidative stress, which reflects the characteristics of an aged patient.

Highlights

Chronic venous insufficiency (CVI) is a disorder of the venous system that prevents the return of blood to the heart [1]
The present study examined the process of valvular incompetence and measured the differential expression of cellular oxidative stress markers according to patient age and how these conditions change the profile of lipid peroxidation as quantified using malondialdehyde (MDA)
Some studies related reflux with weakening of the venous walls [23], which may be due to an imbalance in the content of collagen and elastin in the vein [24]

Summary

Introduction

Chronic venous insufficiency (CVI) is a disorder of the venous system that prevents the return of blood to the heart [1]. IVC is not a serious pathology, but it occurs with a high incidence in the population [2, 3]. Available pharmacological treatments are not effective, and surgery is the treatment of choice when the disease progresses. Venous hypertension often occurs due to reflux caused by incompetent venous valves [12]. These valves decrease the venous pressure, which favors the return of blood to the heart, and tolerate high pressures for limited periods of time. Events that modify the structure of these valves will trigger valvular incompetence and generate a blood reflux that progressively increases the venous pressure in the leg [13]

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