Harnessing the lymphatic system.

IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Barbara Ponikowska, Marat Fudim, Gracjan Iwanek, Robert Zymliński, Jan Biegus
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引用次数: 0

Abstract

Heart failure (HF) is a growing concern, with significant implications for mortality, morbidity, and economic sustainability. Traditionally viewed primarily as a hemodynamic disorder, recent insights have redefined HF as a complex systemic syndrome, emphasizing the importance of understanding its multifaceted pathophysiology. Fluid overload and congestion are central features of HF, often leading to clinical deterioration and hospital admissions, with the role of the lymphatic system previously largely overlooked, partly due to diagnostic challenges and visualization difficulties. With the advancement of those techniques, pathophysiological changes occurring in the lymphatic system during HF, such as enlargement of the thoracic duct and the increased lymphatic flow, are now becoming apparent. This emerging research has begun to uncover the interplay between lymphatic dysfunction and HF, suggesting novel therapeutic targets. Advances in molecular biology, such as targeting vascular endothelial growth factor and promoting lymphangiogenesis, hold promise for improving lymphatic function and mitigating HF complications. This article provides a comprehensive overview of the evolving landscape of lymphatic system-targeted therapies for HF. It explores various intervention levels, from mechanical lymphatic decongestion to pharmaceutical interactions and lymphatic micro-circulation, offering insights into future directions and potential clinical implications for HF management.

利用淋巴系统
心力衰竭(HF)是一个日益受到关注的问题,对死亡率、发病率和经济可持续性都有重大影响。传统上,心力衰竭主要被视为一种血液动力学疾病,但最近的研究将心力衰竭重新定义为一种复杂的全身综合征,强调了了解其多方面病理生理学的重要性。体液超负荷和充血是心房颤动的主要特征,常常导致临床病情恶化和入院治疗,而淋巴系统的作用以前在很大程度上被忽视,部分原因是诊断困难和可视化困难。随着这些技术的进步,高血压期间淋巴系统发生的病理生理学变化,如胸腔导管扩大和淋巴流量增加,现已变得显而易见。这项新兴研究已开始揭示淋巴功能障碍与高血压之间的相互作用,并提出了新的治疗目标。分子生物学的进步,如针对血管内皮生长因子和促进淋巴管生成,为改善淋巴功能和减轻高频并发症带来了希望。本文全面概述了以淋巴系统为靶点的高血压治疗方法的演变情况。文章探讨了从机械性淋巴减充血到药物相互作用和淋巴微循环等各个干预层面,为高频房颤治疗的未来方向和潜在临床意义提供了见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Heart Failure Reviews
Heart Failure Reviews 医学-心血管系统
CiteScore
10.40
自引率
2.20%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Heart Failure Reviews is an international journal which develops links between basic scientists and clinical investigators, creating a unique, interdisciplinary dialogue focused on heart failure, its pathogenesis and treatment. The journal accordingly publishes papers in both basic and clinical research fields. Topics covered include clinical and surgical approaches to therapy, basic pharmacology, biochemistry, molecular biology, pathology, and electrophysiology. The reviews are comprehensive, expanding the reader''s knowledge base and awareness of current research and new findings in this rapidly growing field of cardiovascular medicine. All reviews are thoroughly peer-reviewed before publication.
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