Low Lymphatic Pumping Pressure in the Legs Is Associated with Leg Edema and Lower Quality of Life in Healthy Volunteers

Lymphat Res Biol. 2015 Jun;13(2):154-9. doi: 10.1089/lrb.2014.0015.

Abstract

Background: Lymph is pumped through the collecting lymphatic vessels by both intrinsic and extrinsic forces, propelling it downstream back into circulation. The intrinsic lymph pump relies on the spontaneous contraction of lymphatic muscles to generate the force of pumping lymph (P(lp)). However, the association between leg edema and reduced leg P(lp) in the general population is unknown. Therefore, this study determined the association of leg P(lp) and edema complaints and quality of life in healthy participants.

Methods and results: A total of 465 healthy volunteers (78 men and 387 women, age 30-85 years) filled out a questionnaire and medical history to rule out severe systemic diseases and local venous/lymphatic diseases. Quality of life was assessed using the Medical Outcome Study Short Form 36 (SF36). Leg P(lp) was measured using minimally invasive indocyanine green fluorescence lymphography and an occlusion cuff technique while sitting. All participants were divided into three groups according to the P(lp) values, as follows: Participants with P(lp) >40 mmHg in both legs, 20 mmHg-40 mmHg in either leg; and <20 mmHg in both legs were divided into the good (n=100), moderate (n=314), and poor (n=51) P(lp) groups, respectively. The survey revealed the poor leg P(lp) group was associated with more frequently complaints of leg edema, as well as lower quality of life than the moderate and good P(lp) groups.

Conclusion: Reduced leg P(lp) is significantly associated with leg edema complaints and lower quality of life in the general population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Healthy Volunteers
  • Humans
  • Leg / pathology*
  • Lymphatic Vessels / physiopathology*
  • Lymphedema / epidemiology*
  • Lymphedema / etiology*
  • Male
  • Middle Aged
  • Quality of Life*