Chronic iliofemoral vein obstruction – an under-recognized cause of exercise limitation‡     

Michael J. Segel  Jacob Luboshitz  Dekel Shlomi  Issahar Ben-Dov 《European Journal of Sport Science》2018,18(7):1022-1028

Local symptoms of chronic venous insufficiency after deep vein thrombosis (DVT) are well described, but little is known about the effect of residual venous obstruction on exercise capacity. We tested our hypothesis that chronic residual iliofemoral vein occlusion (IFVO) after DVT may impair exercise capacity. Nine post-DVT patients with residual IFVO and effort intolerance were studied; a comparison cohort consisted of 11 healthy volunteers. Exercise tolerance was assessed by bimodality incremental symptom-limited cardiopulmonary testing, using leg and arm ergometers. In healthy subjects, leg vein obstruction was modelled by application to the thighs of cuff tourniquets inflated to 30–40?mmHg. Leg exercise tolerance as measured by oxygen uptake at peak exercise (peak ?’O₂) was reduced in patients (median 50% predicted (range 36–83%) vs. 88% predicted (67–129%) in normal subjects, p?2 was 0.95 (0.77–1.43) in patients vs. a normal ratio of 0.73 (0.6–1.0) in healthy subjects (p?2 in leg exercise to 76% predicted (range 55–108%; p?相似文献