PDF(Pubmed)
Abstract：
The lymphatic system plays a crucial, yet often overlooked, role in maintaining fluid homeostasis, and its dysregulation is a key feature of heart failure (HF). Lymphatic dysregulation in patients with HF typically results from a combination of self-perpetuating congestive mechanisms, such as increased fluid filtration, decreased lymph drainage into the central venous system, impaired lymph vessel integrity, dysfunctional lymphatic valves, and dysfunctional renal lymphatic system. These pathomechanisms collectively overwhelm the lymphatic system and hinder its ability to decongest the interstitial space with subsequent manifestation and progression of clinical congestion. Targeting the lymphatic system to counteract these congestive pathomechanisms and facilitate interstitial fluid removal represents a novel pathway to treat congestion in HF. In this study, we discuss the physiological roles of the lymphatic system in fluid homeostasis and the pathophysiological alteration of these roles in HF. We also discuss innovative technologies that aim to use the lymphatic system pathway to treat congestion in HF and provide future directions related to these approaches.
摘要：
淋巴系统起着至关重要的作用，但经常被忽视，在维持体液稳态方面的作用，它的失调是心力衰竭（HF）的一个关键特征。HF患者的淋巴调节异常通常是由自我持续的充血机制的组合引起的。例如增加流体过滤，减少淋巴引流到中心静脉系统，淋巴管完整性受损，功能失调的淋巴瓣膜，和功能失调的肾脏淋巴系统。这些病理机制共同压倒了淋巴系统，并阻碍了其缓解间质空间的能力，随后出现临床充血和进展。靶向淋巴系统以抵消这些充血病理机制并促进间质液去除是治疗HF充血的新途径。在这项研究中,我们讨论了淋巴系统在液体稳态中的生理作用以及这些作用在HF中的病理生理改变。我们还讨论了旨在使用淋巴系统途径治疗HF充血的创新技术，并提供与这些方法相关的未来方向。
