Myocardial Lysosomes in Experimental Atrial Septal Defects

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Abstract
Preliminary observations in patients undergoing open-heart surgery have suggested that the lysosomes in the right atrium are increased in patients with atrial septal defects. This increase in lysosomes per myocardial cell appears to be directly related to the size of the left to right shunt. The following experiments were performed to see if similar findings could be produced in an experimental model. Atrial septal defects were produced in seven dogs. The biopsy specimens were prepared for ultrastructural examination and viewed with an electron microscope. Lysosomes were counted in representative sections and an estimate of the lysosomes per square micron of heart tissue obtained. The number of lysosomes per square micron of myocardium increased significantly following the creation of atrial septal defects in dogs, with the most marked increase occurring in the right ventricle. Several small atrial septal defects closed spontaneously, as proved by cardiac catheterization, and in these animals the elevated lysosome counts present initially returned toward normal after obliteration of the left to right shunt at the atrial level. Control dogs showed no significant increase in myocardial lysosomes over the 18-month period despite repeated thoracotomies and myocardial biopsy. These studies add further evidence to support the role of the lysosome as an important intracellular organelle which is related to cellular stress.