Francisco Epelde: Cardiac Lymphatic System as an Active Regulator of Myocardial Homeostasis
Francisco Epelde, Attending Physician, internal Medicine Service at Parc Taulí University Hospital, posted on LinkedIn about his recent article, published in Medical Sciences, adding:
“I am pleased to share my latest article, ‘Cardiac Lymphatic Dysfunction in Heart Failure: A New Paradigm for Congestion, Inflammation, and Therapy,’ published in Medical Sciences.
Heart failure has traditionally been understood through hemodynamic, neurohormonal, and cardiorenal models.
However, these frameworks do not fully explain persistent tissue congestion, unresolved myocardial edema, chronic inflammation, and progressive fibrosis despite optimized therapy.
In this review, I explore the cardiac lymphatic system as an active regulator of myocardial homeostasis.
Rather than being a passive drainage network, cardiac lymphatics may play a central role in linking congestion, inflammation, fibrosis, and ventricular dysfunction.
The article highlights emerging evidence suggesting that lymphatic dysfunction could represent a missing mechanistic bridge in heart failure pathophysiology, while also opening new possibilities for diagnosis, phenotyping, and future therapeutic strategies focused on tissue-level decongestion and lymphatic repair.
Although clinical translation remains investigational, recognizing lymphatic insufficiency as part of the heart failure process may help us rethink how we understand congestion and myocardial remodeling.
I hope this review contributes to the growing discussion around new biological paradigms in heart failure.”
Title: Cardiac Lymphatic Dysfunction in Heart Failure: A New Paradigm for Congestion, Inflammation, and Therapy
Author: Francisco Epelde

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