Miller A J, DeBoer A, Palmer A
Department of Medicine, Northwestern Memorial Hospital, Chicago, IL 60611.
Med Hypotheses. 1992 Jan;37(1):31-6. doi: 10.1016/0306-9877(92)90009-2.
Arguments are presented to support the hypothesis that the integrity of the coronary lymphatic system is an important factor in the development of coronary atherosclerosis. It is proposed that the lymphatic drainage of the epicardial coronary arteries is genetically inadequate, and that the flow of lymph from the heart is further impaired by gravitational factors due to man's upright position. Arguments are presented to support the concept that the intramural coronary arteries are protected from atherosclerosis because of a highly effective pericoronary lymphatic and venous capillary system and that the internal thoracic (internal mammary) artery is similarly protected from atherosclerosis because of its close relationship to an extensive lymphatic chain. It is proposed that the failure of the cardiac lymphatic system in the allogenic transplanted heart is a cause of the accelerated atherosclerosis in both epicardial and intramural coronary arteries.
冠状动脉淋巴系统的完整性是冠状动脉粥样硬化发展的一个重要因素。有人提出，心外膜冠状动脉的淋巴引流在遗传上是不足的，并且由于人类的直立姿势，重力因素会进一步损害心脏的淋巴流动。文中提出了一些论据来支持这样的观点，即壁内冠状动脉由于高效的冠状动脉周围淋巴和静脉毛细血管系统而免受动脉粥样硬化的影响，并且胸廓内（乳内）动脉由于与广泛的淋巴链密切相关而同样免受动脉粥样硬化的影响。有人提出，同种异体移植心脏中心脏淋巴系统的功能衰竭是心外膜和壁内冠状动脉加速动脉粥样硬化的一个原因。
