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      Venous Pressure Dynamics of the Healthy Human Leg

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          Abstract

          The delicate interplay between the muscle-joint unit and intact venous valves is mandatory for normal venous blood return from the human leg. We have investigated the potential role of (1) muscle activity and joint mobility, and (2) anthropometric factors for peripheral venous pressure physiology. 20 healthy young subjects (10 males, 10 females; mean age: 25.6 ± 3.1 years) underwent direct venous blood pressure measurements during walking on a treadmill in 12 experimental conditions (duration, 1 min each): these resulted from a combination of two different walking velocities, two different degrees of ascent, and three different walking conditions. Anthropometric parameters (e.g., body height, weight and calf circumference) were also measured in all subjects. Outcome measures were the pressures (mm Hg) during quiet standing (resting pressure, P₀), the maximal activity-induced pressure reduction (ΔP<sub>max</sub>), i.e., the difference between the resting pressure (P₀) and minimal pressure during exercise (P<sub>min</sub>), the times (s) to minimal pressure during exercise (T<sub>Pmin</sub>) and to half-maximal recovery of P₀ after exercise (T<sub>max1/2</sub>). We found that the maximal venous pressure reduction (ΔP<sub>max</sub>) during walking increased at the higher walking speed and decreased with restricted joint mobility (p = 0.0001). Taller and heavier subjects, or subjects with a greater calf circumference had higher P₀ (p = 0.0001), showed greater ΔP<sub>max</sub> (p < 0.010), and took longer to achieve minimal pressure during exercise (T<sub>Pmin</sub>; p < 0.010) than their corresponding counterparts. Females had lower levels of P₀ (p = 0.0001), but not of ΔP<sub>max</sub>, and shorter T<sub>Pmin</sub> (p = 0.0076) than males. These gender effects largely result from differences in body height, weight, and calf circumference (p = 0.0001 for the appropriate ANOVA interaction terms). We conclude that during walking, a higher degree of muscle activity and a greater muscle mass enhance venous emptying of the healthy human leg. Conversely, impairments of joint mobility reduce the efficacy of the muscle-vein pump. Moreover, body height and weight significantly influence venous pressure physiology under both resting and activity-related conditions. These anthropometric factors also largely explain sex differences in peripheral venous hemodynamics.

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          Author and article information

          Journal
          JVR
          J Vasc Res
          10.1159/issn.1018-1172
          Journal of Vascular Research
          S. Karger AG
          1018-1172
          1423-0135
          2001
          February 2001
          08 February 2001
          : 38
          : 1
          : 20-29
          Affiliations
          Klinik und Poliklinik für Angiologie, Universitätsklinikum – Gesamthochschule Essen, Deutschland
          Article
          51026 J Vasc Res 2001;38:20–29
          10.1159/000051026
          11173991
          © 2001 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 2, Tables: 3, References: 32, Pages: 10
          Categories
          Research Paper

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