The high concentration and rapid turnover of cholesterol-rich lipoproteins in cardiac lymph suggest interstitial lipoprotein dynamics may contribute to the coronary bed's predilection for atherosclerosis.
Cardiac lymph lipoprotein data should not change practice; animal findings leave open interstitial contributions to coronary atherosclerosis.
The cardiac lymphatic system of pigs was found to consist of valved efferent lymph vessels draining into a cardiac lymph node, which is similar to the lymphatic system found in dog and man. The interstitial lipoproteins of the heart were studied by sampling cardiac efferent lymph in anesthetized fasting pigs (n -4) and dogs (n 5). In pigs, the lymph flow rate was 2.0 0.7 ml/hr (mean SRM) and in dogs, 1.2 0.3 ml/hr. The total cholesterol concentration was 54.9 8.0 and 33.8 6.3 mg per 100 ml in cardiac lymph of piga and dogs, respectively. The ratio of lymph :plasma cholesterol differed in the two species: 0.82 in pigs and 0.46 in dogs. More than 90% of cardiac lymph cholesterol was recovered in high density lipoprotein (HDL) and in low density lipoprotein (LDL) in both pigs and dogs. In pigs, LDL wag the major cholesterol-carrying lipoprotein in plasma and lymph, whereas in canine plasma and lymph, this was HDL. The appearance of '"I-LDL in canine cardiac lymph following iv administration was rapid and reached a plateau by 1 hour. The t'A appearance of '"I-LDL in lymph was 5 minutes compared to tV4 clearance of plasma (rapid phase) of 44 minutes. The lymph: plasma ratio of LDL specific activity wai 0.48 0.15, suggesting continuous addition of cold LDL in the interstitial space. The high concentration and turnover of cholesterol-rich lipoprotein in cardiac lymph suggest that the predilection of the coronary bed for atherosclerotic degeneration may be a function of the interstitial lipoprotein concentration and composition as well as the plasma concentration of lipoprotein species.
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Julien et al. (1981) studied this question.
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