Adults With Left-Sided Pressure Loading Lesions.

OPINION STATEMENT: Adults with congenital heart disease represent a growing population. Now, more adults are living with congenital heart disease than children. Thus, adult cardiologists are likely to care for patients with either new diagnoses of congenital heart defects or complications of previously diagnosed defects or their interventions. In the present article, we review congenital conditions that lead to left-sided pressure overload states, specifically, subaortic stenosis, aortic stenosis, and coarctation of the aorta. We discuss the anatomy, epidemiology, and diagnosis of these specific lesions and review the current literature for management considerations.

Microsomal Ca2+ flux modulation as an indicator of heavy metal toxicity.

Inositol 1,4,5-trisphosphatee (IP3), an intracellular messenger, releases Ca2+ from microsomes. Ca2+ plays a major role in regulating various cellular events like neural transmission and regulation of hormones and growth factors. Aluminum (Al), lead (Pb) and mercury (Hg) were reported to alter Ca(2+)-regulated events thereby causing neurotoxicity. Hence, an attempt was made characterize IP3 mediated Ca2+ release from rat brain microsomes under the influence of Al, Pb and Hg. Different concentrations of metals were tested over a designated time scale and their effects on IP3 mediated Ca2+ release from microsomes were monitored using Fura-2 technique. All the three metals inhibited IP3 mediated Ca2+ release, Pb being more potent. The order of potency of these three metals was Pb>Hg>Al. Except for Al, both Hg and Pb independently released Ca2+ from microsomes. Re-uptake of Ca2+ into microsomes was inhibited by all the three metals, Pb being more potent. Microsomal Ca(2+)-ATPase activity was also inhibited by all the three metals. These results suggest that neurotoxicity exerted by Al, Pb and Hg may be due to the interference of these metals with IP3 mediated calcium release and also interfering with the microsomal Ca2+ sequestration mechanism. Differential effects of heavy metal induced changes in Ca2+ flux can be used as an index of relative toxicity.