title: Low Lymphatic Pumping Pressure in the Legs Is Associated with Leg Edema and Lower Quality of Life in Healthy Volunteers.
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.
  
  
  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.
  
  
  CONCLUSIONS
  Reduced leg P(lp) is significantly associated with leg edema complaints and lower quality of life in the general population.
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Takaaki
authors.initials: T
authors.lastname: Saito
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Naoki
authors.initials: N
authors.lastname: Unno
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Naoto
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Kazunori
authors.initials: K
authors.lastname: Inuzuka
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Masaki
authors.initials: M
authors.lastname: Sano
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Ryota
authors.initials: R
authors.lastname: Sugisawa
authors.affiliation: 1 Division of Vascular Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .|2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Kazuto
authors.initials: K
authors.lastname: Katahashi
authors.affiliation: 2 Second Department of Surgery, Hamamatsu University School of Medicine , Hamamatsu, Japan .
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007866:Leg / Q000473:pathology*; D042601:Lymphatic Vessels / Q000503:physiopathology*; D008209:Lymphedema / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life