Left ventricular deformation in patients with lymphedema before and after the use of medical compression stockings—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

BACKGROUND: Lymphedema (LE) is a chronic condition, which refers to tissue swelling due to excess interstitial fluid accumulation or impaired lymphatic conduit. Theoretically, lymphedema-related fluid retention could affect left ventricular (LV) mechanics, which could be detailed by recent three-dimensional speckle-tracking echocardiography. Therefore, it was purposed to examine LV strains in LE patients before and one hour after the use of medical compression stockings and to compare findings to those of matched normal subjects. METHODS: The study comprised 26 cases with lymphedema, however, 4 cases had to be excluded due to inferior quality of images. Their results were compared to 27 age- and gender-matched healthy controls. RESULTS: Global LV circumferential and area strains and mean segmental LV circumferential strain were increased in lymphedema patients before the use of medical compression stockings as compared to controls. One hour after the use of medical compression stockings, no global and mean segmental LV strain showed significant impairment or improvement, but tendentious reduction was seen in LV circumferential strain. With LV segmental analysis, midventricular LV radial, circumferential and area strains proved to be significantly increased, while basal LV longitudinal strain and midventricular LV three-dimensional strain were decreased as compared to controls. No changes in regional LV strains could be detected after one-hour medical compression stockings use as compared to data collected at rest. CONCLUSIONS: Increased global LV circumferential strain is seen in lymphedema. With using medical compression stockings, LV deformation parameters change towards the normal range emphasizing their importance on cardiac function.