The amount and distribution of myocardial lipopigments ('age pigments') were studied in alcoholic and control human hearts, to test the hypothesis of ethanol-induced long-term oxidative damage in myocardium. The amount of myocardial lipopigments was measured by image analysis in six men (age 34-60 years) who had a history of chronic alcohol misuse and who died of acute ethanol intoxication, and in their age-matched, non-alcoholic controls. Lipopigmentation in the intoxication cases was 33.5 +/- 2.8% (mean +/- SEM) higher compared to the controls in the eight myocardial areas studied (P < 0.001). A linear correlation of myocardial lipopigmentation with age was noticed in both the intoxication group (R = 0.894) and the controls (R = 0.927). The amount of lipopigments varied largely from one myocardial area to another, being highest in the most strained areas (left ventricle, interventricular septum). The accumulation of lipopigments is considered a marker of oxidative stress and ageing in the myocardium. The results support the role of free radical-induced oxidative stress in the pathogenesis of ethanol-induced cardiac abnormalities.