Biochemical
and Bioimaging Endpoints in Cardiocerebrovascular Diagnosis,
Prevention, Therapy and Drug Development
GLOSSARY
To
facilitate the dialogue among the multidisciplinary scientists,
definition of the acronyms and of more specialized terms have been
reported.
Every amendment is welcome.
By: Andrea P. Peracino
Stefano Bellosta
Nicola Ferri
Riccardo Roggeri
A measure of closeness of agreement between a test result and an accepted reference value.The degree of conformity of an indicated value to an accepted standard value, or ideal value. links Accuracy Rating - A number of quantity defining a limit that errors will not exceed when a device is used under specified operating conditions. Accuracy rating can be expressed in a number of forms, i.e. in terms of the measured variable (± 1°C), percent of span (± 0.5% of span), percent of upper range value (± 0.5% of upper range value F.S.), percent of scale length (± 0.5% of scale length), or percent of actual output reading (± 1% of actual output reading). Measured Accuracy - The maximum positive and negative deviation observed in testing a device under specified conditions and by a specified procedure. It is usually measured as an inaccuracy and expressed as accuracy, typically in terms of the measured variable, percent of span, percent of upper range variable, percent of scale length, or percent of actual output reading. See accuracy, accuracy rating.
ACE (angiotensin-converting enzyme) inhibitor - A medicine that lowers blood pressure by interfering with the breakdown of a protein-like substance involved in blood pressure regulation.
The application of probability and statistical methods to calculate the risk of occurrence of any event, such as onset of illness, recurrent disease, hospitalization, disability, or death. It may include calculation of the anticipated money costs of such events and of the premiums necessary to provide for payment of such costs.
Adverse Drug Event syn: Adverse Drug Error : Any incident in which the use of a medication (drug or biologic) at any dose, a medical device, or a special nutritional product (for example, dietary supplement, infant formula, medical food) may have resulted in an adverse outcome in a patient.
Adverse Drug Reaction - ADR An undesirable response associated with use of a drug that either compromises therapeutic efficacy, enhances toxicity, or both.
An untoward, undesirable, and usually unanticipated Event, such as death of a patient, an employee, or a visitor in a health care organization. Incidents such as patient falls or improper administration of medications are also considered adverse events even if there is no permanent effect on the patient
Aldosterone is a steroid hormone synthesized from cholesterol by the enzyme aldosterone synthase. It is formed in the outer-section (zona glomerulosa) of the adrenal cortex of the adrenal gland, as the cells of other sections don't have the corresponding enzyme. It is the sole endogenous member of the class of mineralocorticoids. It helps regulate the body's electrolyte balance by acting on the mineralocorticoid receptor.
An explicit step-by-step procedure for producing a solution to a given problem. Specifically, a mathematical equation typically executed using a computer program (or set of programs) that is designed to systematically solve a certain kind of problem.
Angina pectoris (chest pain): A type of pain usually described as choking, squeezing, or suffocating, usually present in the chest, throat, jaw, shoulders, arms or elbows. Most commonly associated with blockage of the heart arteries. adj: Stable AnginaAngina , Unstable Angina
allows direct visualization of the surface on the internal wall of the artery identifying plaques, presence of thrombus, and macroscopi features: as tears, ukcerations and fissures
Angiotensin II is the final active messenger of the renin-angiotensin pathway Angiotensin II binds to AT1 receptors to cause vasoconstriction and fluid retention, both of which lead to an increase in blood pressure. The angiotensin II receptor blockers lower blood pressure by blocking the AT1 receptors.
Artificial neural networks- a tool for clinical decision: a computerised mathematical model for understanding and predicting complex and chaotic dynamics in complex biological systems. A type of artificial intelligence that attempts to imitate the way a human brain works. Rather than using a digital model, in which all computations manipulate zeros and ones, a neural network works by creating connections between processing elements, the computer equivalent of neurons. The organization and weights of the connections determine the output. Neural networks are particularly effective for predicting events when the networks have a large database of prior examples to draw on.
Acute Physiology and Chronic Health Evaluation, a scoring system using routinely collected data and providing an accurate, objective description for a broad range of intensive care unit admissions, measuring severity of illness in critically ill patients.
Apolipoprotein A-I (apoA-I) is the primary protein constituent of HDL, defining its size and shape, solubilizing its lipid components, removing cholesterol from peripheral cells, activating the LCAT enzyme, and delivering the resulting cholesterol esters to the liver.
Apolipoprotein B (apo B) exists in human plasma as two isoforms, apo B-48 and apo B-100. Apo B-100 is the major physiological ligand for the LDL receptor. It is a large monomeric protein , containing 4536 amino acid residues. Apo B-100 is synthesised in the liver and is required for the assembly of very low density lipoproteins (VLDL). It does not interchange between lipoprotein particles, as do the other lipoproteins, and it is found in IDL and LDL particles after the removal of the apolipoproteins A, apolipproteins E and apolipoproteins C.
Apo B-48 is present in chylomicrons and chylomicron remnants and plays an essential role in the intestinal absorption of dietary fats. Apo B-48 is synthesised in the small intestine.
Absolute RiskRisk : RiskRisk of having a disease. If the incidence of a disease is 1 in 1000, then the absolute risk is 1 in 1000 or 0.1%. see also Relative Risk
Absolute Risk Reduction: is the difference in the event rate between control group (CER) and treated group (EER): ARR = CER - EER.
Case-control Study involves identifying patients who have the outcome of interest (cases) and control patients without the same outcome, and looking back to see if they had the exposure of interest.
A disease process, commonly called "hardening of the arteries", which includes a variety of conditions that cause artery walls to thicken and lose elasticity.
Arrhythmogenic Right Ventricular Cardiomyopathy is characterised by a progressive replacement of normal right ventricular muscle cells by fibrous tissue and fat.
under control in the diagnostic department are: internal and external monitoring, quality control,instrumentations, methods validation, procedures manual, comparison of tests results
imprecision: distance of agreement between independent results of measurement obtained under stipulated conditions. Imprecision is a qualitative concept, a quantitative counterpart of iprecision. Imprecision is computed as a standard deviation or a coefficient of variation of the measurement results. Imprecision depends critically on the specified conditions. Standard deviation expressing imprecision may depend on the value of the measurand; the phenomenon is called heteroscedasticity.
computer entry and management of data. Quality assurance. Report generation. Integration of multitests results pereingin the single patient. Dialogue and consultancy to the ward and clinicians. Dialogue and consultancy to the patients and family. Clinical report delivery. Specimen storage.method re-evaluation. Protocols re-evaluation. Guidelines re-evaluation. Personnel safety. Personnel formation and updating. Errors evaluation and prevention.
Assay Preanalytical Factors in Medicine Laboratory
Specimen Collection, Handling, and Transport to the Laboratory. . Specimen Identification. Test Identification.Specimen Accessioning. Client Communication and Education. Personnel Safety. Laboratory Environment. Personnel Requirements.
A type of cardiac arrhythmia during which the atria (i.e. the top chambers of the heart) beat in an uncoordinated and disorganized fashion thus leading to a very irregular and fast rhythm.
Area Under Curve -A statistical means of summarizing information from a series of measurements on one individual. It is frequently used in clinical pharmacology where the AUC from serum levels can be interpreted as the total uptake of whatever has been administered. As a plot of the concentration of a drug against time, after a single dose of medicine, producing a standard shape curve, it is a means of comparing the bioavailability of the same drug made by different companies.
Continuous measurement of a process, product, or service compared to those of the toughest competitor, to those considered industry leaders, or to similar activities in the organization in order to find and implement ways to improve it. This is one of the foundations of both total quality management and continuous quality improvement. Internal benchmarking occurs when similar processes within the same organization are compared. Competitive benchmarking occurs when an organization's processes are compared with best practices within the industry. Functional benchmarking refers to benchmarking a similar function or process, such as scheduling, in another industry.
Inclusive terms used to quantify the positive expected results or outputs of a proposed activity, project, or program expressed in monetary or non-monetary terms. Ideally, estimates of all benefits, outputs, or effectiveness expected to be received or achieved as a result of undertaking a proposed activity, program, or project. adj: clinical Benefit ,economic Benefit, Social Benefit, incremental Benefit. see: Risk/Benefit
Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases.Beta blockers block the action of epinephrine and norepinephrine on the ß-adrenergic receptors in the body (primarily in the heart, peripheral blood vessels, bronchi, pancreas, and liver). There are three types of beta receptors: ß1-receptors located mainly in the heart, and ß2-receptors located all over the body, but mainly in the lungs, muscles and arterioles. ß3-receptors are less well characterised, but have a role in fat metabolism.
The probability distribution associated with two mutually exclusive outcomes; used to model cumulative incidence rates and prevalence rates. The Bernoulli distribution is a special case of binomial distribution
the Variability observed when a quantity is measured in different specimens from the same individual obtained over a time span.this variability is due to both imprecision of the measurement procedure, the metrological variability, and the rhythmic and random fluctuations of the quantity value around a virtual homeostatic set point, the intra-individual biological variability.
A characteristic that is objectively measured (by biochemical, or imaging methodology, including molecular medicine) and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.
• Biomarker is a cellular, or molecular indicator of exposure, health effects, or susceptibility.
• Biomarker can be detected, or described, by chemical, physical, and physico-chemical methodologies
• Biomarker can be represented by a measure (biochemical), or a morphology (imaging), or a function
• Biomarkers can be used to inform about an internal dose, a biologically effective dose, an early biological response, an altered structure or function, a susceptibility
Body Mass Index: a number that doctors use to determine the risk of cardiovascular disease created by a person being overweight. BMI is calculated using a formula of weight in kilograms divided by height in meters squared (BMI =W [kg]/H [m2]). There is a tendency to susbtitute in the adults the BMI by the Waist to Hip ratio
Brain Natriuretic Peptide Type B. links : Pro-pro BNP, pro BNP, BNP-32, pro-BNP77/08, B405+B288 Atrial and Ventricular cardiomyocites produce proANP (1-126) and proBNP(1-108) rispectively. Which are subsequentely cleaved in Amino Terminal NT terminals with different numer of aminoacids. Myocite stretch and volume overload both stimulate the release of ANP and BNP as well as thir amino-termonal counterparts.
The force or pressure exerted by the heart in pumping blood; the pressure of blood in the arteries. adj: Diastolic pressure, The pressure of blood inside arteries when the heart is at rest. Systolic pressure: The pressure of blood inside arteries when the heart contracts.
Ultrasound technique to test for elasticity of the brachial artery after a release of a restriction placed on the upper arm for a period of time. This is a proposed diagnostic test for Cardio Vascular Diseases - CVD.
A brain tumor is any intracranial mass created by an abnormal and uncontrolled growth of cells either normally found in the brain itself (neurons, glial cells - astrocytes, oligodendrocytes, ependymal cells, lymphatic tissue, blood vessels), in the cranial nerves (myelin producing cells Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumors).
Coronary Artery Bypass:- Surgical rerouting of blood around a diseased vessel that supplies the heart. Done by grafting either a piece of vein from the leg or the artery from under the breastbone.
Coronary Artery Disease: A condition caused by thickening of the walls of the arteries that supply blood to the heart muscle. When these arteries become blocked, the heart is deprived of oxygen and can become damaged. Severe cases can result in heart atta
A mathematical calculation related to the amount of calcium determined by multiplying the area of calcified plaque by a weighting factor based on the CT number or Hounsfield unit of the calcified plaque. Weighted volume of calcium.
Set of operations that establish, under specified conditions, the relationship between values of quantities indicated by a measuring instrument or measuring system, or values represented by a material measure or a reference material and the corresponding values realized by standards
A material that is used to adjust instrumentation that is based on or traceable to a reference preparation or material, and whose values are determined by acceptable reference methods.
A table showing the performance of each calibrator with respect to the calibration response curve, giving for each calibrator:
- Concentration: The nominal calibrator concentration. - the Ybar: the average response - the XCalc: the estimated concentration from the average response for the calibrator. - Nominal: the result from XCalc divided by the value of the nominal concentration, expressed as a percentage. - Replicates: the number of replicates for the calibrator.
"
The local injection of pure inflammatory mediators induces venular or capillary leakage. Vascular leakage in aseptic inflammation is biphasic, first venular, then capillary; the capillary phase is induced by the inflammatory reaction itself, possibly through a form of diffuse angiogenesis."
Plaque inflammation in the carotid arteries is a major risk factor for Stroke. Atherosclerotic plaque typically develops around the region of the internal and common carotid artery bifurcation. Knowledge of the differential wall motion displacements across the carotid bifurcation in normal and in diseased arteries may thus be useful in the study of atherosclerotic disease. An important clinical application is the identification of high-risk plaques that are vulnerable to rupture, leading to stroke. It is hoped the vulnerable plaque may be predicted by identifying pertinent features of the carotid plaque wall motion behaviour throughout the cardiac cycle.
Carotid vessel narrowing is a relatively poor predictor of strokerisk; most patients with severe carotid artery narrowing remain stroke-free for over 5 years without treatment, although surgery or medication may be employed when significant carotid plaque is found
Various ultrasound techniques have been used to detect and track the vessel wall motion. Computational techniques have mainly been based on analysis of the B-mode greyscale images , M-mode [, analyses of the raw RFultrasound data and Doppler techniques . Tissue Doppler Imaging (TDI) is a relatively new commercial technique, originally developed for imaging the myocardium, which has found increasing applications in echocardiography. TDI is basically a colour Doppler technique that has been optimised to provide images of tissue motion rather than blood flow, and is capable of high spatial and temporal resolution. The signal processing techniques employed to extract the tissue velocity information from the RFultrasound data are typically based on time domain cross-correlation techniques or autocorrelation techniques.
Classification and Regression Tree: basically a bivariate, explorative methodology using binary recursive partitioning to classify patients in homogeneous, clinically important “risk groups” and is also particularly suitable to detect complex interactions.
Caspase-3 (CPP32, apopain) has been identified as being a key mediator of apoptosis of mammalian cells and is belonging to the family of asparate-specific cysteinyl proteases or caspases..
is a transmembrane glycoprotein expressed by B lymphocytes, but also detected on other cell types or tumors, particularly carcinomas. As for CD40L, CD40 is part of a large protein family, the TNF-receptor family. The CD40L trimer is expected to bind three CD40 molecules, very much in the same way the TNFbeta trimer binds three TNF-55R receptors.
CVD forms: Cerebral embolism: a blood clot formed in one part of the body and then carried by the bloodstream to the brain, where it blocks an artery. Cerebral hemorrhage: bleeding within the brain resulting from a ruptured blood vessel, aneurysm, or head injury. Cerebral thrombosis: Formation of a blood clot in an artery that supplies part of the brain.
chest pain is a symptom of a number of serious conditions and is generally considered a medical emergency. The nature of the pain and the circumstances of it appearance together the medical examination and semeyotic should distinguish angina, the pain of myocardial infarction, the pain associated with a dissecting aneurysm, a pleuric pain, a chest trauma, and other clincal situations
n-Chimerin: GTPase activating protein that is specific for RAC GTP-BINDING PROTEINS. It is expressed primarily in the brain and may be involved in signal transduction. The alternatively spliced form of CHIMERIN 1 (alpha-2 Chimerin) contains an additional src homology domain and is expressed in both the brain and testes.
A distribution in which a variable is distributed like the sum of the the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
a lipid that occurs naturally in the body, in animal fats and in dairy products, and that is transported in the blood. Limited quantities are essential for the normal development of cell membranes. Links: Total Cholesterol : TC. HDL Colesterol: HDL-C. LDLCholesterol: LDL-C
Choline is generated by the cleavage of membrane phospholipis by phospholipase Whole Blood Choline - WPCHO and olasma Choline (PCHO) concentrations increase after stimulation of phospholipase D (PLD) and the activation of surfaces receptors in choronary plaque destabilization
The rhythmic repetition of certain phenomena in living organisms at about the same time each day. Without cues provided by light, the human circadian cycle lasts 25.9 hours.
A treatment regime, agreed upon by consensus, that includes all the elements of care, regardless of the effect on patient outcomes. It is a broader look at care and may include tests and x-rays that do not affect patient recovery. syn: Clinical path.
Is a systematically developed statement designed to assist practitioner and patient make decisions about appropriate health care for specific clinical circumstances.
