The Role of Lymph Circulation in Congestive Heart Failure

Abstract

1) In generalized phlebohypertension "true lymph flow" in the unopened, intact thoracic duct is much less, than that obtained from the transsected and cannulated duct. 2) Congestive heart failure is among other, well known causes precipitated by the "haemodynamic insufficiency" of the lymph system. 3) Chronic increase of superior vena pressure may lead to clot formation in the thoracic duct and other large lymph trunks, thus totally blocking lymph flow. By calling attention to this fact an until now unrecognised cause of resistance to therapy in cases of congestive heart failuse has been described. 4) Elevation of inferior vena cava pressure was in spite of previous bilateral nephrectomy accompanied in contrast to the finding of Katz and Cockett by an increased thoracic duct lymph flow. 5) The theory of Katz and Cockett, according to which Sodium retention in congestive heart failure can be explained by lymphatic back transport of Sodium into the blood stream instead of beeing excreted into the urine has been invalidated. 6) The mechanism outlined by Katz and Cockett may play an important role in various pathologic conditions characterised by isolated renal venous and/or inferior vena cava phlebohypertension.