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

Abstract

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.