Coronary microvascular dysfunction is associated with impaired cognitive function: the Cerebral-Coronary Connection...

Area of Science:

• Cardiology
• Neurology
• Vascular Biology

Background:

• Coronary microcirculatory dysfunction (CMD) and cerebral small vessel disease (CSVD) are distinct conditions.
• The relationship between CMD and CSVD, particularly in patients with coronary artery disease (CAD), remains unclear.

Purpose of the Study:

• To investigate the prevalence of CMD in patients with CAD.
• To assess the association between CMD, CSVD, and cognitive function in these patients.

Main Methods:

• Prospective blinded study (C3) involving 67 CAD patients.
• Physiological assessment of coronary microcirculation (coronary flow reserve - CFR).
• Brain MRI, transcranial Doppler (TCD), and neurocognitive testing.

Main Results:

• 55.2% of patients had abnormal CFR (<2.0).
• Low CFR correlated with increased white-matter hyperintensities, reduced grey matter volume, and white-matter microstructural damage.
• Low CFR was also associated with abnormal cerebral flow (TCD) and poorer cognitive test performance.

Conclusions:

• CMD is prevalent in CAD patients and is associated with CSVD, impaired cerebral hemodynamics, and cognitive impairment.
• These findings support a unified pathological process of microvascular dysfunction in both the heart and brain in CAD patients.