Coronary artery endothelium was studied in 13 human hearts removed in the course of heart transplants. Plasma cholesterol ranged from 60 to 240 mg/dl (median 151). In all cases, abundant endothelial lipid and lipofuscin droplets were found, with images of transition between the two types; ultrastructural evidence indicated that lipofuscin derived both by fusion of smaller lipofuscin droplets as well as by oxidation of lipid droplets. There was no evidence of lipofuscin generation by autophagocytosis as seen in other organs. It is concluded that endothelial lipofuscin is not "wear-and-tear pigment" but a byproduct of lipid oxidation, a process normally carried out by the endothelial cells. In the endothelium of human veins, lipofuscin granules were much smaller and rare; this points to a biological difference between arterial and venous endothelium.
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