Department of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Department of Dermatology and Allergology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
ESC Heart Fail. 2021 Oct;8(5):4328-4333. doi: 10.1002/ehf2.13487. Epub 2021 Jul 20.
Lower body half compression of bilateral secondary leg lymphoedema (LE) without relevant cardiac insufficiency gives rise to whether external leg compression may influence left ventricular (LV) function. Patients with LE were subjected to baseline two-dimensional transthoracic echocardiography (2DTTE) for general assessment then three-dimensional speckle-tracking echocardiography (3DSTE) before and 1 h after lower body half external compression for LV torsion analysis.
Baseline 2DTTE was performed in the cohort of 25 LE patients, and the results were compared with those of age- and gender-matched 52 healthy controls (mean age: 47.8 ± 12.8 vs. 40.7 ± 14.0 years, 24 women/1 man vs. 49 women/3 men, respectively). 3DSTE was conducted for the assessment of LV rotational mechanics where apical (AR), and basal rotations (BR) were measured before and 1 h after the use of compression class 2 (ccl 2) flat-knitted medical compression pantyhoses (pressure range: 23-32 mmHg). 2DTTE showed significantly larger LV end-diastolic volume and ejection fraction among LE patients compared with control subjects (108.3 ± 20.1 vs. 98.5 ± 21.7 mL, 69.8 ± 4.8 vs. 65.5 ± 4.3%, respectively) and notably smaller LV end-systolic diameter and posterior wall thickness (28.9 ± 3.5 vs. 31.2 ± 3.4 mm, 8.1 ± 1.0 vs. 9.0 ± 1.7 mm, respectively). The results of 20 patients with LE were considered in 3DSTE examinations due to the drop-out of five probands with technical failures. The data of four LE patients showing significant LV rotational abnormalities were managed separately, and the rotational parameters of the remaining sixteen patients did not differ significantly from those of matched controls except significant reduction of LV BR following the application of medical compression stockings (MCS) (-2.70 ± 1.26 degrees after 1 h use of pantyhose in patient group vs. -4.28 ± 2.18 degrees of the control group; P < 0.05).
The application of compression pantyhoses moderately but significantly decreased LV BR without a remarkable impact on twisting mechanism in LE patients in the absence of LV rotational abnormalities.
对双侧继发性腿部淋巴水肿（LE）的下肢下半部进行双侧压缩，如果没有相关的心功能不全，会导致外部腿部压缩是否会影响左心室（LV）功能。将 LE 患者置于基线二维经胸超声心动图（2DTTE）进行一般评估，然后在外部下肢下半部压缩前和 1 小时后进行三维斑点追踪超声心动图（3DSTE），以进行 LV 扭转分析。
在 25 例 LE 患者的队列中进行了基线 2DTTE，将结果与年龄和性别匹配的 52 名健康对照者进行了比较（平均年龄：47.8±12.8 岁比 40.7±14.0 岁，24 名女性/1 名男性比 49 名女性/3 名男性）。进行 3DSTE 评估 LV 旋转力学，测量使用压缩 2 级（ccl 2）平纹针织医用压缩连裤袜（压力范围：23-32mmHg）前后的心尖（AR）和基底旋转（BR）。与对照组相比，LE 患者的 2DTTE 显示出更大的 LV 舒张末期容积和射血分数（108.3±20.1 比 98.5±21.7mL，69.8±4.8 比 65.5±4.3%），并且 LV 收缩末期直径和后壁厚度明显更小（28.9±3.5 比 31.2±3.4mm，8.1±1.0 比 9.0±1.7mm）。由于 5 名患者出现技术故障，有 20 名 LE 患者的结果考虑了 3DSTE 检查。由于 4 名 LE 患者出现明显的 LV 旋转异常，对四名 LE 患者的数据进行了单独处理，其余 16 名患者的旋转参数与对照组相比没有显著差异，除了使用医用压缩袜后 LV BR 明显减少（患者组使用连裤袜 1 小时后为-2.70±1.26 度，对照组为-4.28±2.18 度；P<0.05）。
在 LE 患者中，应用压缩连裤袜可适度但显著降低 LV BR，而不会对扭转机制产生显著影响，在不存在 LV 旋转异常的情况下。
