In vivo flux of plasma cholesterol into human abdominal aorta with advanced atherosclerosis

To measure the flux of free and esterified cholesterol from plasma into abdominal aortic tissue that had severe atherosclerotic lesions, we intravenously injected two autologous plasma samples containing radioactive cholesterol into patients scheduled for reconstructive arterial surgery. After the injections, blood samples were collected for calculation of the exposure of arterial tissue to labeled free and esterified plasma cholesterol. When tissue specimens were removed a few days after the injection, the aortic influx was determined by the simultaneous use of two differently labeled species of cholesterol. The flux of free and esterified cholesterol into 51 tissue specimens from the abdominal aorta of 12 normocholesterolemic patients was 41 +/- 3 and 45 +/- 3 nmol X cm-2 X day-1 (mean +/- SE), respectively, with 7% to 30% hydrolysis and 8% to 24% esterification of the labeled sterols in the atherosclerotic tissue. The influx was up to 100 times greater than the influx into nonatherosclerotic ascending aorta previously measured in other patients. The cholesterol content of the atherosclerotic tissue corresponded to 16 +/- 3 months (mean +/- SE) of continuous cholesteryl ester influx. Unless counteracted by cholesteryl ester efflux from the plaque, this influx provides enough cholesteryl ester from plasma to cause rapid lesion progression.