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Review
. 2021 Jul 6;78(1):66-76.
doi: 10.1016/j.jacc.2021.04.090.

Lymphatic Dysregulation in Patients With Heart Failure: JACC Review Topic of the Week

Marat Fudim  1 , Husam M Salah  2 , Janarthanan Sathananthan  3 , Mathieu Bernier  4 , Waleska Pabon-Ramos  5 , Robert S Schwartz  6 , Josep Rodés-Cabau  7 , François Côté  8 , Abubaker Khalifa  9 , Sean A Virani  3 , Manesh R Patel  10
Affiliations
Free article
Review

Lymphatic Dysregulation in Patients With Heart Failure: JACC Review Topic of the Week

Marat Fudim et al. J Am Coll Cardiol. .
Free article

Abstract

The lymphatic system is an integral part of the circulatory system and plays an important role in the volume homeostasis of the human body. The complex anatomy and physiology paired with a lack of simple diagnostic tools to study the lymphatic system have led to an underappreciation of the contribution of the lymphatic system to acute and chronic heart failure (HF). Herein, we discuss the physiological role of the lymphatic system in volume management and the evidence demonstrating the dysregulation of the lymphatic system in HF. Further, we discuss the opportunity to target the lymphatic system in the management of HF and different potential approaches to accessing the lymphatic system.

Keywords: congestion; heart failure; lymphatic system.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Fudim was supported by K23HL151744 from the National Heart, Lung, and Blood Institute (NHLBI), the American Heart Association grant no. 20IPA35310955, Mario Family Award, Duke Chair’s Award, Translating Duke Health Award, Bayer, and BTG Specialty Pharmaceuticals; and has received consulting fees from AstraZeneca, AxonTherapies, CVRx, Daxor, Edwards LifeSciences, Galvani, and NXT Biomedical. Dr Sathananthan has served as a consultant for NXT Biomedical. Dr Pabon-Ramos has served as a consultant for NXT Biomedical, Guerbet, and Medtronic. Dr Schwartz has served as a consultant for NXT Biomedical. Dr Khalifa is an employee of NXT Biomedical. Dr Patel has received research grants from AstraZeneca, Bayer, Janssen, Procyrion, and Heartflow; and is on the advisory board for Bayer, Janssen, Mytonomy, and Procyrion. NXT Biomedical has applied for a patent related to therapy targeting the lymphatic system. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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