The Susceptibility of Dogs with Chronic Impairment of Cardiac Lymph Flow to Staphylococcal Valvular Endocarditis

Nine of 16 dogs (56 per cent) with surgically produced chronic impairment of cardiac lymph flow developed acute endocarditis of the mitral valve or acute myocarditis, or both, after intravenous injections of staphylococci, while none of 10 unoperated control dogs did. The results show that chronic impairment of cardiac lymph flow predisposes to staphylococcal endocarditis and myocarditis. Impairment of cardiac lymph drainage may be important in explaining certain poorly understood pathologic processes in man. Thus, impaired lymph flow may predispose to bacterial endocarditis, recurrent rheumatic carditis, and myocarditis. It may be one of the alterations which perpetuates chronic inflammatory processes in the heart valves and in the myocardium. Inflammation and fibrosis in turn may predispose to impairment of lymph flow, and the latter in its turn will predispose to further inflammation, infection, and fibrosis. Thus a vicious cycle is established. A hypothesis concerning the role of cardiac lymphatics in...