Ventricular Endomyocardial Changes after Impairment of Cardiac Lymph Flow in Dogs.

The mammalian heart has an extensive lymphatic system (Patek, 1939) which has been given little attention in the published reports on cardiovascular systems. Our interest in the cardiac lymphatics was stimulated by the possibility that obstruction to their flow might cause endocardial changes. Reasoning by analogy with elephantiasis and similar conditions due to interference with lymph flow, we postulated that endomyocardial fibrosis or endocardial fibro-elastosis or both might follow chronic impairment of cardiac lymph flow. This was tested in the dog. Our preliminary studies (Miller, Pick, and Katz, 1960) established that endomyocardial changes are produced by chronic interference with the cardiac lymph flow. The present communication is a final report of a more extended series of observations in which we tested our hypothesis more precisely. This expanded survey also permitted a clearer definition of the sequence of pathological events that follow chronic impairment of cardiac lymph flow in the dog.