Cardiovascular Cardiometabolic Journal (2020) 2, 77-81 https://e-journal.unair.ac.id/CCJ © 2020 Cardiovascular Cardiometabolic Journal E-mail: ccj@journal.unair.ac.id ABSTRACT Before molecular medicine era, the lymphatic system was not getting enough attention in medicine world, especially in cardiovascular medicine. Our knowledge about lymphatic system is far left behind compare to vascular system. Many believes lymphatic function is isolated in regulate interstitial fluid hemostasis, fat transport, and immune transport. In deep investigation in lymphatic function shows that alteration in lymphatic vessel could disrupt normal cardiovascular function. Moreover, optimal cardiac lymphatic condition after post-heart tissue injury could enhance tissue regeneration. That is why in modern medicine era preserving optimal lymphatic condition and treat abnormal lymphatic condition might be beneficial in cardiovascular medicine. Review Lymphatic Disease in Cardiology: The Forgettable One S. L. Purwowiyoto 1,2* , N. Anggriyani 3 , and S. P. Surya 4 1 Head of Cardiac Catheterization Laboratory, Department of Cardiology and Vascular Medicine, RSUD Pasar Rebo, East Jakarta. 2 Faculty of Medicine, Universitas Muhammadiyah Prof. DR. Hamka, Tangerang, Indonesia. 3 Department Cardiology and Vascular Medicine, RSUP dr. Karyadi, Universitas Diponegoro, Semarang, Central Java. 4 Army Hospital Kesdam Jaya Cijantung, Jakarta, Indonesia. Introduction Discussion The lymphatic system is still a mystery box in the modern medicine world. Even it has fundamental relation with other diseases such as cardiovascular, infection, immunology, metabolic, and cancer, many practitioners presume it clinically insignificant [1]. There are several major functions of lymphatic system like immune transport, tissue fluid hemostasis, and absorption of dietary lipid. 2 Together with blood vascular system, the lymphatic vasculatures found in most of the vascularized tissues and complement the blood vessel. However, they both quite different in morphology and function. 3 Beside lack of interest, the lymphatic system is a transparent vessel that make it difficult to observe [1,2]. a. Lymphatic Endothelial Cells (LEC) Lymphatic vessels are unidirectional flow and compose of a single layer of endothelial cell. Ultra- structure morphology of LEC is slightly different compare to the endothelial cell in the blood vessels; more thin, irregular and wider [4]. Unique LEC configuration, overlapping flaps LEC adherence with each other with intercellular junctions in their base and make button-like structure, permits interstitial fluid, macromolecule, and cell enter the lumen more easily [2,4]. The tight junction of the LEC is rich with protein and vascular endothelial cadherin [2]. However lymphatic vessel is very dependent with their extracellular matrix (ECM) to prevent collapse of the vessel and lymphangiogenesis [4]. The lymphatic vessels connect with ECM with anchoring filaments that can ARTICLE INFO Article history: Submitted August 2020 Reviewed September 2020 Accepted September 2020 Available online September 2020 *Corresponding author: sidhilaksono@uhamka.ac.id Keywords: Lymphatic System Lymphatic Function Lymphatic Disease