RESUMEN
This paper introduces a novel method of binary classification of cardiovascular abnormality using the time-frequency features of cardio-mechanical signals, namely seismocardiography (SCG) and gyrocardiography (GCG) signals. A digital signal processing framework is proposed which utilizes decision tree and support vector machine methods with features generated by continuous wavelet transform. Experimental measurements were collected from twelve patients with cardiovascular diseases as well as twelve healthy subjects to evaluate the proposed method. Results reveal an overall accuracy of more than 94% with the best performance achieved from SVM classifiers with GCG training features. This suggests that the proposed solution could be a promising method for classifying cardiovascular abnormalities.
Asunto(s)
Anomalías Cardiovasculares/diagnóstico , Procesamiento de Señales Asistido por Computador , Análisis de Ondículas , Anomalías Cardiovasculares/clasificación , Árboles de Decisión , Electrocardiografía , Humanos , Máquina de Vectores de SoporteRESUMEN
Cardiovascular malformations are a singularly important class of birth defects and due to dramatic improvements in medical and surgical care, there are now large numbers of adult survivors. The etiologies are complex, but there is strong evidence that genetic factors play a crucial role. Over the last 15 years there has been enormous progress in the discovery of causative genes for syndromic heart malformations and in rare families with Mendelian forms. The rapid characterization of genomic disorders as major contributors to congenital heart defects is also notable. The genes identified encode many transcription factors, chromatin regulators, growth factors and signal transduction proteins- all unified by their required roles in normal cardiac development. Genome-wide sequencing of the coding regions promises to elucidate genetic causation in several disorders affecting cardiac development. Such comprehensive studies evaluating both common and rare variants would be essential in characterizing gene-gene interactions, as well as in understanding the gene-environment interactions that increase susceptibility to congenital heart defects.
Asunto(s)
Anomalías Cardiovasculares/genética , Animales , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/epidemiología , HumanosRESUMEN
La medición del riesgo cardiovascular en un mismo grupo de personas del área mediterránea española arroja resultados diferentes según la herramienta que se elija, incluso aunque las herramientas empleadas utilicen los mismos parámetros para determinar el riesgo. (AU)
Asunto(s)
Impactos de la Polución en la Salud/clasificación , Impactos de la Polución en la Salud/métodos , Impactos de la Polución en la Salud/prevención & control , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/epidemiología , Anomalías Cardiovasculares/prevención & control , EspañaRESUMEN
La medición del riesgo cardiovascular en un mismo grupo de personas del área mediterránea española arroja resultados diferentes según la herramienta que se elija, incluso aunque las herramientas empleadas utilicen los mismos parámetros para determinar el riesgo.
Asunto(s)
Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/epidemiología , Anomalías Cardiovasculares/prevención & control , España , Impactos de la Polución en la Salud/clasificación , Impactos de la Polución en la Salud/métodos , Impactos de la Polución en la Salud/prevención & controlRESUMEN
This study compared the prevalence of cardiovascular defects in twin and singleton births and explored the influences of zygosity (monozygotic and dizygotic) and maternal age (<35 and >or=35 years of age) on concordance. Data on twin and singleton infants with (n = 628 twin pairs and n = 14,078 singletons) and without (n = 53,974 twin pairs and n = 4,858,255 singletons) cardiovascular defects were obtained from the California Birth Defects Monitoring Program and the California vital statistics birth and fetal death records during the period 1983-2003. Prevalence ratios (PR) (prevalence of twin/singleton) and approximate 95% confidence intervals were calculated for 16 congenital cardiovascular categories. Poisson regression techniques using log-linear models were employed to assess whether the probability of concordance of defects within each cardiovascular category varied by zygosity or maternal age. An increased prevalence was observed in twins compared to singletons in all 16 cardiovascular categories. Seven of the cardiovascular categories had at least double the prevalence in twins compared to singletons. Like-sex twins, as a proxy of monozygosity, had an increased prevalence of cardiovascular defects compared to unlike sex twins. Probabilities of concordance for flow lesions were higher among monozygotic than dizygotic twins. Our study provides evidence that twinning is associated with more cardiovascular defects than singletons. Increased concordance for flow lesions in monozygotic twins was observed, an observation that is in agreement with findings from familial recurrence studies of cardiovascular defects.
Asunto(s)
Anomalías Cardiovasculares/epidemiología , Enfermedades en Gemelos/epidemiología , Adolescente , Adulto , California/epidemiología , Anomalías Cardiovasculares/clasificación , Enfermedades en Gemelos/clasificación , Femenino , Humanos , Masculino , Edad Materna , Persona de Mediana Edad , Prevalencia , Gemelos Dicigóticos , Gemelos Monocigóticos , Adulto JovenRESUMEN
Vascular anomalies are a complex pathological group. They are especially difficult to study because of confusion in the terminology used. The classification developed by the ISSVA (International Society for the Study of Vascular Anomalies) now allows using a common scientific language. The classification is based on clinical, radiological, hemodynamic, and histological arguments. There are two groups of lesions: vascular tumors and vascular malformations. Vascular tumors are associated to vascular proliferation. They are called hemangioma and can be infantile or congenital. Vascular malformations are associated to vessels with morphologic anomalies. They are classified according to the distorted vessel type, capillary, venous, lymphatic, and arteriovenous). Such a classification has many implications. It is a guide for the orientation of radiological exams and treatment of vascular anomalies. The management of these anomalies is still difficult and must involve an interdisciplinary approach.
Asunto(s)
Malformaciones Arteriovenosas/clasificación , Vasos Sanguíneos/anomalías , Hemangioma/clasificación , Neoplasias Vasculares/clasificación , Malformaciones Arteriovenosas/terapia , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/terapia , Clasificación , Hemangioma/terapia , Humanos , Terminología como Asunto , Neoplasias Vasculares/terapiaRESUMEN
Vascular ring is a term given to a combination of vascular and often ligamentous structures that encircle the trachea and esophagus. The diagnosis can be difficult because clinical symptoms can be variable and nonspecific, and because vascular arrangements that result in vascular rings in some patients do not form vascular rings in others. The clinical manifestations comprise a spectrum ranging from no symptoms to feeding difficulties, repeated infections, and life-threatening respiratory compromise. The diagnosis of vascular ring can be made by various imaging modalities. Therefore it is imperative that pediatric radiologists be familiar with the anatomic variants that can result in a symptomatic ring needing surgical repair, their imaging appearance and the appropriate imaging algorithm. The goals of this manuscript are to describe common and uncommon types of vascular rings, to simplify the differential diagnosis, and to outline the imaging options for accurate diagnosis.
Asunto(s)
Aorta Torácica/anomalías , Aorta Torácica/patología , Diagnóstico por Imagen/métodos , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/diagnóstico , Niño , Estenosis Esofágica/diagnóstico , Estenosis Esofágica/etiología , Humanos , Arteria Subclavia/anomalías , Arteria Subclavia/patología , Estenosis Traqueal/diagnóstico , Estenosis Traqueal/etiologíaRESUMEN
The failure of embryonic vascular arches to fuse and regress in the usual manner during the formation of the aortic arch, pulmonary arteries and ductus arteriosus can cause a wide spectrum of vascular congenital abnormalities of the aortic arch and its branches. These abnormal vascular structures may cause variable compression of the trachea and/or oesophagus with symptoms ranging from none to severe stridor, dyspnoea, dysphagia and cyanosis. Diagnosis and possible treatment of affected patients require multiple imaging modalities. In the majority of cases, the underlying malformation can be detected by chest radiography and barium oesophagography, visualizing the location of the aortic arch and the presence of anomalous compressions of the trachea and/or oesophagus. However, in most cases the exact configuration of the vascular abnormality cannot be fully defined with conventional radiology alone. MRI is fundamental for evaluation of the thoracic vessels. Not only is it non-invasive, but it can also provide large-field-of-view images in any number of planes with three-dimensional reconstruction, adding valuable information about exact vascular configuration, tracheobronchial compression and brachiocephalic vessel branching. The aim of this review is to describe the imaging findings in children affected with special emphasis on MRI.
Asunto(s)
Aorta Torácica/anomalías , Aorta Torácica/patología , Imagen por Resonancia Magnética , Aorta Torácica/embriología , Sulfato de Bario , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/diagnóstico , Niño , Medios de Contraste , Esófago/diagnóstico por imagen , Gadolinio DTPA , Humanos , Imagenología Tridimensional , Arteria Pulmonar/anomalías , Arteria Pulmonar/patología , Radiografía , Arteria Subclavia/anomalías , Arteria Subclavia/patologíaAsunto(s)
Anomalías Cardiovasculares/clasificación , Adolescente , Niño , Preescolar , Humanos , Lactante , Recién NacidoAsunto(s)
Cardiopatías Congénitas/clasificación , Terminología como Asunto , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/diagnóstico , Preescolar , Bases de Datos Factuales , Femenino , Control de Formularios y Registros , Cardiopatías Congénitas/diagnóstico , Humanos , Lactante , Recién Nacido , Cooperación Internacional , Masculino , Sensibilidad y Especificidad , Organización Mundial de la SaludRESUMEN
Vascular anomalies comprise a widely heterogenous group of tumors and malformations. Great confusion has arisen because of the term hemangioma has been and is continued to be used to represent a multitude of vascular entities. This review presents the updated classification of vascular anomalies with the goal of clarifying the term hemangioma. In addition, newer clinical concepts in hemangiomas and other vascular tumors is presented. Hemangioma subtypes and hemangioma variants are also discussed, and a brief review of pyogenic granuloma and Kaposiform hemangioendothelioma is provided. Finally, the immunohistochemical marker GLUT1 is reviewed, a marker that heralds a new era in vascular anomalies research.
Asunto(s)
Anomalías Cardiovasculares/diagnóstico , Endotelio Vascular/patología , Hemangioma/diagnóstico , Anomalías Cardiovasculares/clasificación , Diagnóstico Diferencial , Femenino , Transportador de Glucosa de Tipo 1 , Granuloma Piogénico/diagnóstico , Hemangioendotelioma/diagnóstico , Hemangioma/clasificación , Hemangioma/patología , Humanos , Inmunohistoquímica , Lactante , Recién Nacido , Masculino , Proteínas de Transporte de Monosacáridos/biosíntesis , Neoplasias Vasculares/clasificación , Neoplasias Vasculares/diagnósticoRESUMEN
Vascular tumors and malformations can be challenging to diagnose. Although they can resemble one another, their classification into tumors, such as hemangiomas of infancy, and malformations, such as venous or arteriovenous malformations, is based not only on their divergent biological behavior, but also on their pathogenesis. This review examines the molecular pathobiology of the processes involved in the development of these vascular birthmarks as they are currently understood. The terms hemangioma, hemangiosarcoma, and vascular proliferation are often used interchangeably, even though these entities are clinically and biochemically distinct. A more precise classification is necessary to facilitate communication between basic scientists and clinicians. Vasculogenesis, the in situ differentiation of blood vessels, occurs very early in the developing embryo. In vivo and in vitro studies, as well as knockout models, seem to indicate that this mechanism is unlikely to be involved in the development of either vascular malformations or hemangiomas of infancy. Recent advances in embryonic angiogenesis, especially explorations of mechanisms of vascular remodeling, have brought new understanding of the pathogenesis of vascular malformations. Vascular remodeling, an integral part of angiogenesis that centers upon the interactions between pericytes and endothelial cells, has been shown to be defective in certain experimental models and in some familial cases of vascular malformation. The occurrences of arteriovenous malformations in territories susceptible to increased remodeling also point towards epigenetic events in the development of vascular malformations.
Asunto(s)
Anomalías Cardiovasculares/diagnóstico , Hemangioma/diagnóstico , Hemangiosarcoma/diagnóstico , Neoplasias Vasculares/diagnóstico , Animales , Vasos Sanguíneos/metabolismo , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/metabolismo , Diferenciación Celular , Proliferación Celular , Diagnóstico Diferencial , Hemangioma/clasificación , Hemangioma/metabolismo , Hemangiosarcoma/clasificación , Hemangiosarcoma/metabolismo , Humanos , Lactante , Recién Nacido , Ratones , Modelos Biológicos , Neovascularización Patológica , Transducción de Señal , Factores de Tiempo , Neoplasias Vasculares/patologíaRESUMEN
BACKGROUND: The International Society for the Study of Vascular Anomalies classification is an updated biologic classification that distinguishes vascular tumors from vascular malformations on the basis of clinical and histologic characteristics and biologic behavior. OBJECTIVE: We propose that in a minority of cases there is an association between vascular tumors and vascular malformations. METHODS: We retrospectively identified clinical cases in our medical centers and others reported in the medical literature that demonstrate an association between vascular tumors and vascular malformation clinically or histologically. RESULTS: We identified several clinical or histologic settings in which vascular tumors and vascular malformations were associated: (1) coexistence of hemangioma and vascular malformation at the same anatomic site or in close proximity; (2) pyogenic granuloma arising within a vascular malformation; (3) hemangioma associated with developmental vascular anomalies; (4) spindle-cell hemangioendothelioma and venous malformation; (5) kaposiform hemangioendothelioma and lymphatic malformation. CONCLUSION: The biologic classification of vascular birthmarks distinguishing vascular tumors from vascular malformations is clinically useful and forms the framework for our understanding of vascular anomalies. These examples suggest that in a small minority of patients there is an association between vascular tumors and vascular malformations.
Asunto(s)
Anomalías Cardiovasculares/clasificación , Granuloma Piogénico/clasificación , Hemangioendotelioma/clasificación , Hemangioma/clasificación , Neoplasias Vasculares/clasificación , Anomalías Cardiovasculares/patología , Transformación Celular Neoplásica , Niño , Preescolar , Comorbilidad , Granuloma Piogénico/patología , Hemangioendotelioma/patología , Hemangioma/patología , Humanos , Incidencia , Lactante , Recién Nacido , Neoplasias Vasculares/patologíaRESUMEN
Epidemiological approaches to the study of cardiovascular malformations (CVMs) face challenges of disease definition, nomenclature, changing diagnostic methodologies, the rarity of the disease in the general population, and the incorporation of current knowledge on genetics and morphogenesis into designing studies to investigate risk factors and implement preventive strategies. Previous studies, especially the population-based Baltimore-Washington Infant Study, have documented variability in the prevalence of specific types of CVM by time, place, and personal characteristics and have highlighted the potential prevention of diabetes-associated heart malformations through timely medical management of pre-conception diabetes. Left-sided obstructive heart defects have been identified as targets for new studies of genetic risk factors. Potential environmental risk factors for CVMs also have been identified, such as organic solvents and pesticides, coincident with the emergence of new strategies to study genetic susceptibility and gene-environment interactions. Increased collaborative, multicenter research on these and other factors, such as nutritional factors in early pregnancy, offers new hope for potentially reducing the burden of CVM in the population.
Asunto(s)
Anomalías Cardiovasculares/epidemiología , Anomalías Inducidas por Medicamentos/epidemiología , Anomalías Inducidas por Medicamentos/etiología , Anomalías Múltiples/epidemiología , Adulto , Anticonvulsivantes/efectos adversos , Baltimore/epidemiología , Anomalías Cardiovasculares/clasificación , Anomalías Cardiovasculares/genética , Anomalías Cardiovasculares/prevención & control , Estudios de Casos y Controles , Diabetes Gestacional/epidemiología , District of Columbia/epidemiología , Femenino , Ácido Fólico/uso terapéutico , Humanos , Lactante , Recién Nacido , Masculino , Exposición Materna , Exposición Paterna , Plaguicidas/efectos adversos , Embarazo , Complicaciones del Embarazo/epidemiología , Prevalencia , Proyectos de Investigación , Factores de Riesgo , Fumar/efectos adversos , Solventes/efectos adversos , Virginia/epidemiologíaRESUMEN
Through an ongoing hospital-based active malformation surveillance program, we identified cardiovascular malformations (CVMs) in 3.3 per 1,000 liveborn and stillborn infants, and fetuses from pregnancies terminated electively during a 15-year period. We excluded the children of mothers who had planned delivery elsewhere, but were transferred for care of anomalies that had been detected in prenatal screening. Birth status changed markedly during the study with a significant increase in elective terminations of fetuses with a CVM from 0 to 22% (P < 0.01 based on a test for trend). The proportion of liveborn infants with CVMs decreased from 90% to 73% (P < 0.01); the frequency of stillbirths did not change. During the study period, there was a significant increase in the prevalence of CVMs in all births (P < 0.01) and elective terminations (P < 0.01). The increase in liveborn prevalence was not statistically significant (P = 0.08). Stillborn prevalence was unchanged. The number of mothers having prenatal ultrasonography (P < 0.01 for trend) and amniocentesis (P < 0.01 for trend) increased steadily. There were significant increases in the proportion of mothers having any ultrasound examination (P < 0.01 for trend), the number of initial ultrasound examinations occurring in the second trimester (P < 0.01 for trend), and the proportion of mothers having amniocentesis (P < 0.01 for trend). There was a significant increasing trend in the proportion of mothers who were 35 years and older (10% in 1972-1974, 26% in 1988-1990, P < 0.01). This hospital-based active surveillance program suggests that more frequent elective terminations had a significant effect on overall birth prevalence of CVMs. This trend would not have been detected by most other surveillance systems which determine prevalence of common birth defects from birth certificates and other forms of administrative reporting, and exclude elective terminations of pregnancy.