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Related Experiment Video

Updated: Nov 24, 2025

Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
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Physical therapy affects endothelial function in lymphedema patients.

B Brix1, G Apich2, C Ure2

  • 1Physiology Division, Otto Loewi Research Center, Gravitational Physiology and Medicine Research Unit, Medical University of Graz, Austria.

Lymphology
|December 22, 2020
PubMed
Summary

Lymphedema patients show normal endothelial function, suggesting no increased cardiovascular risk. Manual lymphatic drainage may improve endothelial function by reducing ADMA levels.

Keywords:
ADMA (asymmetric dimethylarginine)complex decongestive therapylymphedemalymphedema therapymanual lymphatic drainagevascular function

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Area of Science:

  • Vascular Biology
  • Lymphatic System Research
  • Cardiovascular Health

Background:

  • Lymphedema results from lymphatic system malfunction, causing significant tissue swelling.
  • Chronic inflammation is often linked to lymphatic dysfunction.
  • Endothelial function and inflammation markers are crucial for cardiovascular health assessment.

Purpose of the Study:

  • To investigate plasma ADMA (asymmetric dimethylarginine) as an indicator of endothelial function and inflammation in lymphedema patients.
  • To assess changes in vascular function parameters during and after complete decongestive therapy (CDT).
  • To explore the relationship between lymphedema, endothelial function, and cardiovascular disease risk.

Main Methods:

  • 13 lower limb lymphedema patients underwent assessment of vascular function parameters (ADMA, PWVcf, FMD, retinal microvasculature).
  • Measurements were taken on days 1, 2, 7, 14, and 21 of CDT, both pre- and post-manual lymphatic drainage (MLD).
  • Statistical analysis was performed to evaluate changes and correlations.

Main Results:

  • Plasma ADMA levels were significantly lower post-MLD and showed a trend of reduction over three weeks of therapy.
  • Carotid-femoral pulse wave velocity (PWVcf) showed a weak correlation with flow-mediated dilation (FMD).
  • No significant changes were observed in PWVcf, FMD, or retinal microvasculature due to physical therapy.

Conclusions:

  • Lymphedema does not appear to negatively impact endothelial function, suggesting a potentially lower cardiovascular disease risk than previously assumed.
  • Manual lymphatic drainage, with or without CDT, may offer beneficial effects on endothelial function in lymphedema patients by reducing ADMA levels.
  • This study provides novel insights into the endothelial and vascular effects of lymphedema and its treatment.