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Abstract

Venous distensibility can be measured in several ways. The most accurate method is to measure changes in volume at different values of congesting pressure. However, venous capacitance at a standard value of congesting pressure does represent a measure of venous distensibility and has been used in other studies.1Gascho JA Fanelli C Zelis R Aging reduces venous distensibility and the venodilatory response to nitroglycerin in normal subjects.Am J Cardiol. 1989; 63: 1267-1270Abstract Full Text PDF PubMed Scopus (40) Google Scholar, 2Borghi C Boschi S Costa FV Ambrosioni E Pattern of peripheral venous response to volume expansion in borderline systemic hypertension.Am J Cardiol. 1990; 66: 597-602Abstract Full Text PDF PubMed Scopus (8) Google Scholar Venous filling is a function of venous distensibility: the more blood the venous bed is able to accept at a determined value of congesting pressure, the more distensible veins are. In our paper,3Ciardullo AV Panico S Bellati C Rubba P Rinaldi S Iannuzzi A et al.High endogenous estradiol is associated with increased venous distensibility and clinical evidence of varicose veins in menopausal women.J Vasc Surg. 2000; 32: 544-549Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar we have clearly stated in the “Methods” section that what we measured was venous capacitance or maximal incremental venous volume (MVIV), and also in the tables we use the term MVIV. Are higher MVIV and varicose veins the same thing, and if one is associated with a parameter, will the other be, too? In most instances the answer is yes, and we acknowledged that limbs with varicose veins have the largest venous capacitance. However, in the same study group evaluated in our paper we found that body mass index, another risk factor for the development of varices, was significantly associated with the presence of varicose veins, whereas no association was found with MVIV. This finding, independent from the influence of endogenous sexual hormones, suggests the hypothesis that distrectual adiposity of the lower limbs could damage drainage veins provoking stasis and contributes to the development of varicose veins. However, in our view, the main message of our paper is the consistency between clinical findings and plethysmographic data with regard to the association with high estrogen values in blood. 24/41/114808