This study investigated (cardiac) remodeling of the myocardial microvasculaturein patients with terminal heart failuredue to ischemic (ICM) and dilative (DCM) cardiomyopathy. Seventeen transmural leftventricular (LV) biopsies (9 ICM and 8DCM), taken from heart transplant recipientsat transplantation (n= 4) or during ventricularassist device implantation (n= 13) were investigatedby immunohistostaining for VEGFR-1and VEGFR-2 as capillary markers andVEGFR-3, D2-40, PROX-1 and LYVE-1 aslymphatic markers. Results were compared toLV biopsies from 7 donor hearts (control). Compared to control, DCM hearts showed asignificantly higher density of LYVE-1 positivelymphatics (p< 0.05), whereas no differencewas seen for other markers. ICM heartsshowed a significantly higher density of D2-40positive lymphatics (p< 0.01) and a lowerdensity of VEGFR-2 capillaries compared tocontrol (p< 0.05). In comparison to normaldonor hearts, ICM and DCM hearts showed asignificantly different pattern of microvascularreceptor expression. As distinct patternswere seen in ICM and DCM, the effect ofmicrovascular remodeling may be substantiallydifferent between two clinically importantcauses of cardiomyopathy. Further researchshould be aimed at defining the impact ofextracellular matrix composition and VEGFrelatedangiogenesis on the myocardial microvasculatureat various stages of heart failure.