Evaluating the Effects of Medical Compression Stockings and Leg Elevation on Inflammatory Biomarkers in CVI and Healthy Subjects

Study aim & design

The aim of this study was to assess the differential effects of gravitational stress, compression therapy and leg elevation on local inflammation.

To this end, the levels of three inflammatory biomarkers (matrix metalloproteinases, annexin V, microparticles) were measured in healthy subjects and CVI patients following three separate conditions: standing without compression, standing with compression, and lying without compression.

Participants

14 healthy subjects (C0-1, “volunteers”) and 14 patients with advanced CVI (C4a-b, “patients”) were enrolled in the study.

Abbreviations

• AV: annexin V
• CVI: chronic venous insufficiency
• MCS: medical compression stockings
• MiPa: microparticles
• MMP: matrix metalloproteinases

Experimental procedure

The experiment was conducted under three different conditions. Each subject acted as its own control and was assessed in all three gravitational states:

Each subject had to stand without MCS, stand with MCS (SIGVARIS COMFORT: 23-32mmHg, below-knee) and lay without MCS with their legs elevated (20-degree angle), for one hour per condition. Following each gravitational state, blood samples from the ankle veins were taken to measure the inflammatory biomarkers MMP, AV and MMP.

Results

Endpoint: Levels of inflammatory biomarkers

Volunteers standing upright while wearing medical compression stockings (MCS) showed a significant reduction in annexin V and microparticles compared to standing without MCS.

Similarly, volunteers with elevated legs showed a significant reduction in microparticles and annexin V compared to standing without MCS.

Patients standing upright while wearing medical compression stockings (MCS) showed a significant reduction in annexin V and matrix metalloproteinases compared to standing without MCS.

Similarily, patients with elevated legs showed a significant reduction in matrix metalloproteinases and annexin V compared to standing without MCS.

Conclusion

MMP, annexin V and microparticle concentrations were reduced in healthy volunteers and CVI patients following compression and leg elevation, when compared to standing without compression.