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Thick sections of plaques from human aortas were dissected to give fractions for lipid analysis which were defined with respect to their morphological characteristics and their position in the plaque.
In fibrous plaques containing no, or very few, fat-filled cells there was a significant positive correlation between percentage of free cholesterol and percentage of oleic acid in the cholesterol ester fatty acids (CEFA) within each tissue fraction, except the cap with low sudanophilia (mainly the surface layers). Percentage of free cholesterol was highest in the deep layers of the amorphous atheroma lipid pool (52%), and there was an almost 1 : 1 relationship with percentage oleic acid in the CEFA (b = −0.924; r = 0.901). In the cap with low sudanophilia the lipid pattern resembled young normal intima.
In plaques containing numerous fat filled cells lipid composition was the same in intact and apparently disintegrating fat-filled cells, but significantly different between apparently disintegrating cells and adjacent layers of the amorphous atheroma lipid pool. The deep layer of the amorphous atheroma lipid was identical with that in fibrous plaques. There was no correlation between free cholesterol and CEFA pattern within any fraction. This suggests that the difference in cholesterol esters between the fat-filled cells and amorphous lipid is due to infiltration of plasma cholesterol ester. It is calculated that, on average, 80% of the amorphous lipid in these large plaques containing numerous fat-filled cells is derived directly from plasma and only 20% from disintegrating fat-filled cells.
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Received in revised form: April 14, 1971
☆This work was wholly supported by the British Heart Foundation to whom the authors are extremely grateful.
© 1971 Published by Elsevier Inc.