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Lymphatic morphology and function in chronic right heart failure due to secondary tricuspid valve regurgitation.
Kelly, Benjamin; Thorup, Lene; Telinius, Niklas; Mohanakumar, Sheyanth; Ringgaard, Steffen; Poulsen, Steen H; Jensen, Jesper K; Hjortdal, Vibeke E.
Afiliación
  • Kelly B; Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. Electronic address: benjaminkelly@clin.au.dk.
  • Thorup L; The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
  • Telinius N; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
  • Mohanakumar S; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
  • Ringgaard S; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; The MR Research Centre, Aarhus University, Aarhus, Denmark.
  • Poulsen SH; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Jensen JK; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Hjortdal VE; The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
Int J Cardiol ; 413: 132399, 2024 Oct 15.
Article en En | MEDLINE | ID: mdl-39069092
ABSTRACT

BACKGROUND:

In heart failure, the capacity of the lymphatic system dictates symptoms of circulatory congestion. This study aimed at describing structural and functional changes of the lymphatic system in patients with chronic right-sided heart failure.

METHODS:

Individuals with long-standing severe tricuspid valve regurgitation and symptoms of heart failure were compared with age- gender- and weight-matched controls. Lymphatic structure and function were examined using non-contrast MR lymphangiography and near-infrared fluorescence imaging. Microvascular fluid dynamics and distribution were evaluated using strain gauge plethysmography and bio-impedance.

RESULTS:

In total nine patients and nine controls were included. Lymphatic morphology was unchanged in cases compared to controls with similar thoracic duct diameters 3.1(2.1-3.5) mm vs. 2.0(1.8-2.4) mm (p-value = 0.11), similar lymphatic classifications (p-value 0.34), and an identical number of lymphatic vessels in the legs 6 ± 1 vs. 6 ± 3 vessels/field (p-value = 0.72). Lymphatic function was comparable with contraction frequencies of 0.5 ± 0.2 and 0.5 ± 0.3 /min (p-value = 0.52) and a maximal lymphatic pumping pressure of 60 ± 13 and 57 ± 12 mmHg (p-value = 0.59) for cases and controls respectively. Finally, microvascular capillary filtration, isovolumetric threshold, and fluid distribution were similar between groups (p-value≥0.16 for all comparisons).

CONCLUSION:

In this small exploratory study, individuals with severe secondary tricuspid valve regurgitation and right-sided heart failure displayed a largely similar lymphatic anatomy and function. Thoracic duct diameter displayed a trend towards increased size in the patient group. We speculate that cases were indeed stable and optimally treated at the time of examination, and with a lymphatic system largely unaffected by any of the current or prior hemodynamic changes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia de la Válvula Tricúspide / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia de la Válvula Tricúspide / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos