LYMPHATIC CARDIOMYOPATHIES - THE ROLE OF LYMPHATIC VESSELS IN DIFFERENT MYOCARDIOPATHIES

Experimental and clinical studies suggest that disorders of cardiac lymph circulation are frequently the causes of cardiomyopathy with arrhythmia. After blockade of the lymph circulation in animal experiments, characteristic histological disorders have been observed, e.g. interstitial and intracellular edema, impairment of myofilaments and mitochondrias, necrosis, fibrosis, and wall degeneration of the small coronary arteries with stenosis. The hemodynamic parameters developing after cardiac lymph blockade are characterized by depression of the cardiac output, elevation of the systemic venous pressure, prolongation of the circulation time, and cardiac enlargement. In the ECG we found a number of abnormalities, e. g. low voltage, ST depression, T inversion and - in 95 % of the cases - arrhythmias in the form of conduction disturbances, sick sinus syndrome, and tachyarrhythmia. After electrical stimulation of the right ventricle, a tachycardia appeared and identical histological alterations have been observed. Also in man after heart surgery, cardiac lymphostasis developed, specimens of the heart muscle showed histological lesions, and frequently arrhythmias appeared. The action potential of the ventricular cell was diminished.