Has the COVID-19 Pandemic Affected Cyberbullying and Cybervictimization Prevalence among Children and Adolescents? A Systematic Review.

In light of the alarming results emerging from some studies and reports on the significant increase in aggressive online behaviors among children and adolescents during the COVID-19 pandemic, the current research aimed at providing a more detailed evaluation of the investigations focusing on the cyberbullying prevalence rates published between 2020 and 2023. To this purpose, systematic searches were conducted on four databases (Web of Science, APA PsycInfo, Scopus and Google Scholar), and following PRISMA guidelines, 16 studies were included and qualitatively reviewed. Although studies were characterized by a large variety in cyberbullying operationalization and measurement, and by different methodologies used for data collection, the prevalence rates of the involvement in cyberbullying and/or cybervictimization generally revealed opposite trends: an increase in many Asian countries and Australia and a decrease in Western countries. The findings were also discussed by considering the effects of the COVID-19 pandemic. Finally, some suggestions were provided to policy makers for promoting prevention and intervention anti-cyberbullying programs in school contexts.

The Long-Term Efficacy and Sustainability of the Tabby Improved Prevention and Intervention Program in Reducing Cyberbullying and Cybervictimization.

Although cyberbullying and cybervictimization prevention programs have proved effective in the short term, their effectiveness remains unclear in the long run. Thus, the present study evaluated the long-term effects of the Tabby Improved Prevention and Intervention Program (TIPIP). Participants were 475 middle and high school students (Mage = 12.38; SD = 1.45; F = 241, 51%), of whom, 167 were in the Experimental Group (EG; Mage = 13.15; SD = 1.52; M = 51.5%), and 308 were in the Control Group (CG; Mage = 13.47; SD = 1.35; M = 47.7%). Students completed measures assessing cyberbullying and cybervictimization at three time points: baseline (T1), immediately after the intervention (6 months, T2), and at 1 year (T3). The results showed no significant effects of the TIPIP in reducing both cyberbullying and cybervictimization over time. Overall, our results confirm the lack of effectiveness of long-term preventive programs and emphasize that different curricula should be implemented in future programs to prevent and manage cyberbullying and cybervictimization, also taking into account psychological mechanisms and processes involved in such behaviors.

Neuropsychiatric Manifestations, Reduced Self-Esteem and Poor Quality of Life in Children and Adolescents with Neurofibromatosis Type 1 (NF1): The Impact of Symptom Visibility and Bullying Behavior.

Neurofibromatosis type 1 (NF1) is an autosomal dominant condition, associated with neurocutaneous manifestations and neuropsychiatric manifestations. The present study explored the prevalence of bullying/cyberbullying behaviors and victimization behaviors in a cohort of children and adolescents with NF1. Possible gender differences and predictors of psychological symptoms, quality of life (QoL), and self-esteem were also examined. Thirty-eight school-aged participants with NF1 completed a psychological evaluation designed to assess anxiety and depression symptomatology, QoL, self-esteem, and the prevalence and extent of bullying/cyberbullying and victimization behaviors. We found that our participants frequently reported victimization behaviors rather than bullying/cyberbullying ones. Moreover, participants complained of depressive and anxiety symptomatology together with reduced self-esteem, and low psychosocial quality of life, with females reporting more severe performances than males. Furthermore, we found that reduced self-esteem was associated with more visibility of the NF1 symptoms, and victimization behaviors were found to mediate the relationship between anxiety and psychosocial QoL. Our findings indicated the presence of a maladaptive loop in children and adolescents with NF1 patients characterized by psychological symptoms, unfavorable self-perception, low self-esteem, and psychosocial difficulties that might be worsened by experiencing victimization behaviors. These results suggest the need to use a multidisciplinary approach in the diagnosis and treatment of NF1.

Risk Factors for Intimate Partner Femicide-Suicide in Italy: An Ecological Approach.

The present study investigated the intimate partner femicide (IPF) and intimate partner femicide-suicide (IPFS) perpetrators' individual, relational, and contextual characteristics by analyzing, within the ecological approach, femicide cases that occurred in Italy from 2010 to 2019. On the topic, to date, scant studies examined possible differences between IPF and IPFS risk factors, and no studies have analyzed these factors by adopting an ecological systems model perspective. To this aim, archival research was carried out. Of a total of 1.207 femicides, 409 were IPF, and 227 were IPFS. Perpetrators' age, level of employment, law enforcement membership, mental and/or physical illnesses, use of psychoactive substances, previous crimes, previous violent relationships, presence of children, previous violence in the couple, inability to accept the end of the relationship, quarrels and conflict, jealousy and the psychophysical illnesses of both authors and victims, as well as the use of firearms and victim's request for help were analyzed. The results underlined the existence of different risk factors contributing to the IPF perpetrators' decision to commit suicide such as perpetrators' age, law enforcement membership, and firearm availability. These findings stress the need for specific risk assessment and management strategies for IPFS perpetrators.

Onset risk factors for youth involvement in cyberbullying and cybervictimization: A longitudinal study.

Introduction: Cyberbullying and cybervictimization are spread worldwide, and due to COVID-19, an increasing number of children and adolescents have been impacted. Since the beginning of the twenty-first century, research has investigated and highlighted the key risk factors for cyberbullying and cybervictimization, and numerous anti-cyberbullying prevention and intervention programs have been developed and assessed for their efficacy. Despite this, no studies have specifically focused on the individual, relational, and contextual risk factors associated with the onset of youth involvement in cyberbullying and cybervictimization. Methods: To address this lacuna, 333 Italian students aged 10-16 years (M = 12.16, SD = 1.35) were involved in a year-long longitudinal study and filled in the anonymous online actuarial Tabby Improved Checklist two times with a 6-month interval. Onset risk factors for cyberbullying and cybervictimization have been separately analyzed by excluding all students involved in cyberbullying from the original sample or in the cybervictimization baseline (T1). Results: The results showed that being male, being involved in school bullying, having low levels of awareness of online risk, and having high levels of affective empathy were all significant onset risk factors for cyberbullying. Similarly, being male, being involved in school bullying and victimization, having high levels of affective empathy, and moral disengagement were onset risk factors for cybervictimization. Conclusion: Given the negative psychological and behavioral consequences of cyberbullying and cybervictimization, this article includes discussions on practical and policy implications for future research, stressing the need to develop, implement, and evaluate the effectiveness of primary prevention programs addressing and managing onset risk factors for cyberbullying and cybervictimization.

Femicide Fatal Risk Factors: A Last Decade Comparison between Italian Victims of Femicide by Age Groups.

Femicide is a wide-spread lethal form of violence against women. Despite its diffusion, to date, very few studies analyzed possible victims' age differences in regard to fatal risk factors for femicide. To this aim, we carried out archive research on Italian femicide cases in the last decade, by comparing prior types of violence suffered and motives for femicide, which are considered crucial fatal risk factors for femicide, across adolescent/young (15-24 years), adults (25-64 years) and older women (65-93 years). From 2010 to 2019 we found 1207 female victims. Characteristics of victims, perpetrators, and their relationship were consistent with those found by international studies and underlined that the majority of femicides were perpetrated by an intimate partner. The results regarding fatal risk factors comparisons across age groups showed the existence of significant differences regarding both types of violence suffered prior to femicide and motives for femicide. The results are discussed in terms of policy implication and intervention.

Multifaceted Role of PRDM Proteins in Human Cancer.

The PR/SET domain family (PRDM) comprise a family of genes whose protein products share a conserved N-terminal PR [PRDI-BF1 (positive regulatory domain I-binding factor 1) and RIZ1 (retinoblastoma protein-interacting zinc finger gene 1)] homologous domain structurally and functionally similar to the catalytic SET [Su(var)3-9, enhancer-of-zeste and trithorax] domain of histone methyltransferases (HMTs). These genes are involved in epigenetic regulation of gene expression through their intrinsic HMTase activity or via interactions with other chromatin modifying enzymes. In this way they control a broad spectrum of biological processes, including proliferation and differentiation control, cell cycle progression, and maintenance of immune cell homeostasis. In cancer, tumor-specific dysfunctions of PRDM genes alter their expression by genetic and/or epigenetic modifications. A common characteristic of most PRDM genes is to encode for two main molecular variants with or without the PR domain. They are generated by either alternative splicing or alternative use of different promoters and play opposite roles, particularly in cancer where their imbalance can be often observed. In this scenario, PRDM proteins are involved in cancer onset, invasion, and metastasis and their altered expression is related to poor prognosis and clinical outcome. These functions strongly suggest their potential use in cancer management as diagnostic or prognostic tools and as new targets of therapeutic intervention.

Searching for a Putative Mechanism of RIZ2 Tumor-Promoting Function in Cancer Models.

Positive Regulatory Domain (PRDM) gene family members commonly express two main molecular variants, the PR-plus isoform usually acting as tumor suppressor and the PR-minus one functioning as oncogene. Accordingly, PRDM2/RIZ encodes for RIZ1 (PR-plus) and RIZ2 (PR-minus). In human cancers, genetic or epigenetic modifications induce RIZ1 silencing with an expression level imbalance in favor of RIZ2 that could be relevant for tumorigenesis. Additionally, in estrogen target cells and tissues, estradiol increases RIZ2 expression level with concurrent increase of cell proliferation and survival. Several attempts to study RIZ2 function in HeLa or MCF-7 cells by its over-expression were unsuccessful. Thus, we over-expressed RIZ2 in HEK-293 cells, which are both RIZ1 and RIZ2 positive but unresponsive to estrogens. The forced RIZ2 expression increased cell viability and growth, prompted the G2-to-M phase transition and organoids formation. Accordingly, microarray analysis revealed that RIZ2 regulates several genes involved in mitosis. Consistently, RIZ silencing in both estrogen-responsive MCF-7 and -unresponsive MDA-MB-231 cells induced a reduction of cell proliferation and an increase of apoptosis rate. Our findings add novel insights on the putative RIZ2 tumor-promoting functions, although additional attempts are warranted to depict the underlying molecular mechanism.

The Efficacy of the Tabby Improved Prevention and Intervention Program in Reducing Cyberbullying and Cybervictimization among Students.

Background. This article presents results from the evaluation of the Tabby Improved Prevention and Intervention Program (TIPIP) for cyberbullying and cybervictimization. TIPIP is theoretically designed to address cyberbullying and cybervictimization. It is the first program in this field developed combining the Ecological System Theory and the Threat Assessment Approach. Method. The Tabby Improved program was evaluated using an experimental design with 759 Italian students (aged 10⁻17 years) randomly allocated via their classes to either the Experimental or Control Group. Results. Repeated measures ANOVAs showed a significant decrease both in cyberbullying and cybervictimization among students who received the intervention with a follow-up period of six months. The program was more effective for boys than for girls. Conclusions. Because cyberbullying is a cruel problem negatively affecting those involved, validated interventions that prove their efficacy in reducing the problem using experimental designs should be widely tested and promoted, paying particular attention to implementing a program fully to increase and guarantee its effectiveness.

PR/SET Domain Family and Cancer: Novel Insights from the Cancer Genome Atlas.

The PR/SET domain gene family (PRDM) encodes 19 different transcription factors that share a subtype of the SET domain [Su(var)3-9, enhancer-of-zeste and trithorax] known as the PRDF1-RIZ (PR) homology domain. This domain, with its potential methyltransferase activity, is followed by a variable number of zinc-finger motifs, which likely mediate protein⁻protein, protein⁻RNA, or protein⁻DNA interactions. Intriguingly, almost all PRDM family members express different isoforms, which likely play opposite roles in oncogenesis. Remarkably, several studies have described alterations in most of the family members in malignancies. Here, to obtain a pan-cancer overview of the genomic and transcriptomic alterations of PRDM genes, we reanalyzed the Exome- and RNA-Seq public datasets available at The Cancer Genome Atlas portal. Overall, PRDM2, PRDM3/MECOM, PRDM9, PRDM16 and ZFPM2/FOG2 were the most mutated genes with pan-cancer frequencies of protein-affecting mutations higher than 1%. Moreover, we observed heterogeneity in the mutation frequencies of these genes across tumors, with cancer types also reaching a value of about 20% of mutated samples for a specific PRDM gene. Of note, ZFPM1/FOG1 mutations occurred in 50% of adrenocortical carcinoma patients and were localized in a hotspot region. These findings, together with OncodriveCLUST results, suggest it could be putatively considered a cancer driver gene in this malignancy. Finally, transcriptome analysis from RNA-Seq data of paired samples revealed that transcription of PRDMs was significantly altered in several tumors. Specifically, PRDM12 and PRDM13 were largely overexpressed in many cancers whereas PRDM16 and ZFPM2/FOG2 were often downregulated. Some of these findings were also confirmed by real-time-PCR on primary tumors.

Cyberbullying in youth: A pattern of disruptive behavior / El ciberacoso en la juventud: Un patrón de comportamiento disruptivo

Despite the growing diffusion of cyberbullying among students and the numerous studies in the literature, to date relatively little is known about its relationship with school bullying. This article seeks to understand if there is an overlap between the roles of bullies and victims in traditional and electronic bullying. In order to investigate this, 5,058 Italian middle and high school students were surveyed about their experiences of cyberbullying and cybervictimisation, looking also at their involvement in school bullying. The results highlighted a significant overlap between school bullying and cyberbullying, with 12.1% of all students who bullied others at least sometimes being also cyberbullies. Similarly, there was a significant overlap between school victimisation and cybervictimisation, with 7.4% of all students who were victimised at school at least sometimes being also cybervictimised. Our findings confirm the existence of an overlap between school bullying and cyberbullying. We discuss useful intervention programs to reduce or prevent cyberbullying

A pesar de que aumenta la extensión del ciberacoso en estudiantes y de los muchos estudios al respecto, se sabe relativamente poco hasta el momento acerca de su relación con el acoso escolar. El artículo trata de entender si hay solapamiento entre los roles de agresor y víctima en el acoso tradicional y electrónico. Con el objeto de investigarlo se encuestó a 5,058 estudiantes italianos de secundaria y bachillerato sobre su experiencia de ciberacoso y cibervictimización, analizando igualmente la implicación en el acoso escolar. Los resultados ponen de manifiesto un solapamiento importante entre el acoso escolar y el ciberacoso: un 12.1% de todos los estudiantes que habían acosado a los demás al menos algunas veces habían sido también ciberacosadores. También había un solapamiento importante entre la victimización escolar y la cibervictimización: 7.4% de los estudiantes victimizados en la escuela al menos algunas veces habían sido también cibervictimizados. Los resultados confirman la existencia de solapamiento entre acoso escolar y ciberacoso. Se comentan programas de intervención útiles para disminuir o evitar el ciberacoso

Alternative Splicing in Adhesion- and Motility-Related Genes in Breast Cancer.

Breast cancer is the most common tumor and the second leading cause of cancer death among woman, mainly caused by the metastatic spread. Tumor invasiveness is due to an altered expression of adhesion molecules. Among them, semaphorins are of peculiar interest. Cancer cells can manipulate alternative splicing patterns to modulate the expression of adhesion- and motility-related molecules, also at the isoform level. In this study, combining RNA-Sequencing on MCF-7 to targeted experimental validations-in human breast cell lines and breast tumor biopsies-we identified 12 new alternative splicing transcripts in genes encoding adhesion- and motility-related molecules, including semaphorins, their receptors and co-receptors. Among them, a new SEMA3F transcript is expressed in all breast cell lines and breast cancer biopsies, and is translated into a new semaphorin 3F isoform. In silico analysis predicted that most of the new putative proteins lack functional domains, potentially missing some functions and acquiring new ones. Our findings better describe the extent of alternative splicing in breast cancer and highlight the need to further investigate adhesion- and motility-related molecules to gain insights into breast cancer progression.

Executive functions in developmental dyslexia.

The present study was aimed at investigating different aspects of Executive Functions (EF) in children with Developmental Dyslexia (DD). A neuropsychological battery tapping verbal fluency, spoonerism, attention, verbal shifting, short-term and working memory was used to assess 60 children with DD and 65 with typical reading (TR) abilities. Compared to their controls, children with DD showed deficits in several EF domains such as verbal categorical and phonological fluency, visual-spatial and auditory attention, spoonerism, verbal and visual short-term memory, and verbal working memory. Moreover, exploring predictive relationships between EF measures and reading, we found that spoonerism abilities better explained word and non-word reading deficits. Although to a lesser extent, auditory and visual-spatial attention also explained the increased percentage of variance related to reading deficit. EF deficits found in DD are interpreted as an expression of a deficient functioning of the Central Executive System and are discussed in the context of the recent temporal sampling theory.

Single-photon emission computed tomography after nitrate administration predicts cardiac events in patients with previous myocardial infarction and left ventricular dysfunction.

BACKGROUND: We determined the impact of viability assessment by nitrate single-photon emission computed tomography (SPECT) on cardiac events during long-term follow-up in patients with previous myocardial infarction, impaired left ventricular (LV) function, and no evidence of inducible ischemia. METHODS AND RESULTS: Sestamibi SPECT after nitrate was performed in 93 medically treated patients with previous myocardial infarction and LV dysfunction (ejection fraction < 40%). Viability was defined as > or = 2 dysfunctional segments with preserved tracer uptake (> or = 55% of peak activity). Cardiac events were cardiac death, myocardial infarction and late revascularization. Sixty-five (70%) patients had evidence of viability at SPECT, whereas 28 (30%) did not. During 43 +/- 24 months of follow-up, cardiac events occurred in 32 (49%) of the 65 patients with viability and in 5 (18%) of the 28 patients without (P < .001). At Cox analysis, only the extent of viability predicted cardiac events (hazards ratio 1.6, 95% CI 1.3-2.0, global chi-square 14.3, P < .0001). Cumulative probability of event-free survival was 22% in patients with viability and 81% in those without (P < .001). CONCLUSIONS: The presence of viable myocardium at nitrate SPECT imaging predicts major cardiac events at long-term follow-up and the risk increases with the extent of viability.

Estimation of coronary flow reserve by sestamibi imaging in type 2 diabetic patients with normal coronary arteries.

BACKGROUND: We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with type 2 diabetes without coronary artery disease and normal coronary vessels. METHODS AND RESULTS: Dipyridamole/rest technetium 99m sestamibi imaging was performed in 33 patients with type 2 diabetes without a history of coronary artery disease and normal coronary vessels at angiography and in 12 control subjects. Myocardial blood flow (MBF) was estimated by measuring first-transit counts in the pulmonary artery and myocardial counts from tomographic images. Estimated CFR was expressed as the ratio of stress MBF to rest MBF. Rest MBF and CFR were corrected for rate-pressure product and expressed as normalized MBF and normalized CFR. At rest, estimated MBF and normalized MBF were not different in control subjects versus patients (0.98 +/- 0.4 counts x pixel(-1) x s(-1) vs 1.42 +/- 0.9 counts x pixel(-1) x s(-1) and 1.14 +/- 0.5 counts x pixel(-1) x s(-1) vs 1.61 +/- 0.9 counts x pixel(-1) x s(-1), respectively). Conversely, stress MBF was higher in control subjects than in patients (2.34 +/- 0.8 counts x pixel(-1) x s(-1) vs 1.55 +/- 0.8 counts.pixel(-1) x s(-1), P < .01). Thus estimated CFR was higher in control subjects than in patients (2.40 +/- 0.3 vs 1.36 +/- 0.8, P < .0001). After correction for the rate-pressure product, normalized CFR was still higher in control subjects than in patients (2.10 +/- 0.5 vs 1.28 +/- 0.8, P < .001). CONCLUSIONS: Sestamibi imaging may detect impaired coronary vascular function in response to dipyridamole in type 2 diabetic patients without a history of coronary artery disease and with normal coronary arteries.

Assessment of coronary flow reserve by sestamibi imaging in patients with typical chest pain and normal coronary arteries.

PURPOSE: We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with typical chest pain, positive exercise stress test and normal coronary vessels. METHODS: Thirty-five patients with typical chest pain and normal angiogram and 12 control subjects with atypical chest pain underwent dipyridamole/rest (99m)Tc-sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first transit counts in the pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of stress to rest MBF. Rest MBF and CFR were corrected for rate-pressure product (RPP) and expressed as normalised MBF (MBF(n)) and normalised CFR (CFR(n)). Coronary vascular resistances (CVR) were calculated as the ratio between mean arterial pressure and estimated MBF. RESULTS: At rest, estimated MBF and MBF(n) were lower in controls than in patients (0.98 +/- 0.4 vs 1.30 +/- 0.3 counts/pixel/s and 1.14 +/- 0.5 vs 1.64 +/- 0.6 counts/pixel/s, respectively, both p < 0.02). Stress MBF was not different between controls and patients (2.34 +/- 0.8 vs 2.01 +/- 0.7 counts/pixel/s, p=NS). Estimated CFR was 2.40 +/- 0.3 in controls and 1.54 +/- 0.3 in patients (p < 0.0001). After correction for the RPP, CFR(n) was still higher in controls than in patients (2.1 +/- 0.5 vs 1.29 +/- 0.5, p < 0.0001). At baseline, CVR values were lower (p < 0.01) in patients than in controls. Dipyridamole-induced changes in CVR were greater (p < 0.0001) in controls (-63%) than in patients (-35%). In the overall study population, a significant correlation between dipyridamole-induced changes in CVR and CFR was observed (r = -0.88, p < 0.0001). CONCLUSION: SPECT might represent a useful non-invasive method for assessing coronary vascular function in patients with angina and a normal coronary angiogram.

Comparison of the prognostic value of SPECT after nitrate administration and metabolic imaging by PET in patients with ischaemic left ventricular dysfunction.

PURPOSE: We compared the prognostic value of 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) after nitrate administration and positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in patients with ischaemic left ventricular (LV) dysfunction. METHODS: Eighty-nine patients with previous myocardial infarction and LV dysfunction (LV ejection fraction 33 +/- 10%) underwent 99mTc-tetrofosmin SPECT under control conditions (baseline) and after sublingual administration of 10 mg of isosorbide dinitrate (nitrate). Within 1 week, all patients underwent PET imaging with 18F-FDG. Four patients were excluded because of inadequate FDG uptake caused by severe diabetes. Follow-up data were obtained by phone contact with patients and by review of hospital or physicians' records. Cardiac death, myocardial infarction and late revascularisation for unstable angina were considered as events. Follow-up data were not available in three patients. Follow-up was 96% complete at a mean period of 29 +/- 19 months. RESULTS: At baseline SPECT, 59 (72%) patients had evidence of viable myocardium, while 23 did not. Of these latter patients, 12 (52%) demonstrated viable myocardium after nitrate and 13 (56%) had preserved metabolic activity. Cardiac events (cardiac death, myocardial infarction and late revascularisation for unstable angina) occurred in 24 (29%) patients. Event-free survival was similar in patients with and patients without viable myocardium at baseline SPECT (p = 0.8). In contrast, event-free survival was lower in patients with viable myocardium at nitrate SPECT and PET compared to those without viable myocardium (both p<0.05). CONCLUSION: In patients with ischaemic LV dysfunction, the prognostic value of SPECT imaging after nitrate is comparable to that of PET metabolic imaging.

Cardiovascular, anthropometric and neurocognitive features of healthy postmenopausal women: effects of hormone replacement therapy.

UNLABELLED: Randomized clinical trials have not shown long-term benefit of postmenopausal hormone replacement therapy (PHT) nor have they shown conclusively that the harmful consequences outweighs the benefits of the treatment. Rather, it is possible that an individualized hormone replacement therapy in questionably clinically healthy postmenopausal women may lead to different results than randomized trials. DESIGN: In this cross-sectional study we evaluated anthropometric parameters, body composition, serum lipids, blood pressure, heart rate variability (HRV) and neurocognitive functions in 39 healthy postmenopausal women PHT users or not users (n=13, age 53.0+/-3.3 and n=26, age=53.3+/-5.0 SD, respectively) as well as in 27 younger controls (ages=33.3+/-7.1). RESULTS: Demographic parameters were similar in women PHT users and not users. Postmenopausal women showed a significantly increase of body mass index (BMI) as well as of waist circumference, compared to younger controls, but in PHT users the values of fat free mass were intermediate between the ones of not treated and younger women. The study of HRV showed a reduction in low frequency (LF) component (sympathetic modulation) during the day, and a reduction in high frequency (HF) component (parasympathetic modulation), particularly in postmenopausal women without PHT. PHT users were characterized by autonomic parameters intermediate between younger controls and age-matched women without PHT. CONCLUSIONS: The impact of PHT on the age-dependent changes of anthropometric features and body composition seems to be modest but positive. Furthermore, PHT seems to play a positive role on the autonomic modulation of cardiac function, through a shift of LF/HF ratio values towards those of young controls.

Relationship between brachial artery flow-mediated dilation and coronary flow reserve in patients with peripheral artery disease.

UNLABELLED: The aim of this study was to assess the relationship between brachial artery flow-mediated dilation (FMD) and coronary flow reserve (CFR) in patients with peripheral artery disease (PAD). METHODS: Thirty patients who had PAD, who showed no cardiac symptoms, and who had normal stress SPECT cardiac imaging results and 28 control subjects underwent brachial artery FMD assessment by ultrasound and dipyridamole 99mTc-sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first-transit counts in the pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of MBF at stress to MBF at rest. RESULTS: Patients with PAD were separated into 2 groups according to the median value of overall FMD (6.85%): group 1 (n=15) with FMD above the median (mean+/-SD, 8.78%+/-1.3%) and group 2 (n=15) with FMD below the median (mean+/-SD, 5.14%+/-0.94%). FMD was significantly higher in control subjects (11.4%+/-3.4%) than in both groups of PAD patients (P<0.001 for both). In control subjects, estimated CFR was 2.2+/-0.4-significantly higher than CFR in both groups of PAD patients (P<0.001 for both). In addition, in PAD patients of group 1, estimated CFR was 1.5+/-0.4-higher than CFR in group 2 (1.0+/-0.4) (P<0.01). When all PAD patients were considered, a significant correlation between FMD and estimated CFR was observed (r=0.56, P<0.005). CONCLUSION: Estimated CFR is significantly lower in patients with PAD than in control subjects, and CFR impairment correlates with the degree of peripheral endothelial dysfunction.

Estimation of coronary flow reserve by Tc-99m sestamibi imaging in patients with coronary artery disease: comparison with the results of intracoronary Doppler technique.

BACKGROUND: This study compared coronary flow reserve (CFR) estimated by technetium 99m sestamibi imaging with the results obtained with intracoronary Doppler in patients with coronary artery disease. Intraobserver and interobserver reproducibility of the radionuclide-estimated CFR was also assessed. METHODS AND RESULTS: Fourteen consecutive patients (mean age, 54 +/- 7 years) with documented coronary artery disease in whom percutaneous coronary intervention was planned underwent dipyridamole (0.74 mg/kg) sestamibi imaging and intracoronary Doppler within 5 days. Myocardial blood flow (MBF) was estimated by measurement of first transit counts in the pulmonary artery and myocardial counts from single photon emission computed tomography images. Estimated CFR was expressed as the ratio of stress MBF to rest MBF. In the study vessels, CFR was 1.36 +/- 0.43 as estimated by sestamibi and 1.39 +/- 0.42 by intracoronary Doppler ( P = .69). A significant relationship between CFR estimated by sestamibi and CFR obtained by intracoronary Doppler was observed ( r = 0.85, P < .001). On Bland-Altman analysis, the mean difference between CFR by sestamibi and by Doppler was 0.03 and the intraclass correlation coefficients for intraobserver and interobserver reproducibility were high (all P < .001) for both global and regional CFR. CONCLUSIONS: This study demonstrates a good agreement between CFR estimated by sestamibi imaging and by intracoronary Doppler results and a lack of intraobserver and interobserver variability of this noninvasive approach.