Mejía Rentería, HernánTravieso, AlejandroYus, MiguelEspejo Paeres, CarolinaFinocchiaro, FrancescaGómez-Escalonilla, Carlos IgnacioGómez Garre, María Dulce NombreGómez de Diego, José JuanModrego Martín, JavierOrtega Hernández, AdrianaPapadopoulos, PetrosMatías-Guiu Guía, JorgeEscaned Barbosa, JavierArrazola García, Juan LorenzoPérez De Isla, LeopoldoBustos García De Castro, Ana MaríaDelgado Álvarez, AlfonsoReneses Prieto, Blanca María AsunciónFernández Guinea, Sara Belén2024-02-072024-02-072022-11-07Mejia Renteria, H., Travieso, A., Yus, M. et al. «Coronary Microvascular Dysfunction Is Associated with Impaired Cognitive Function: The Cerebral-Coronary Connection Study (C3 Study)». European Heart Journal, vol. 44, n.o 2, enero de 2023, pp. 113-25. DOI.org (Crossref), https://doi.org/10.1093/eurheartj/ehac521.0195-668X1522-964510.1093/eurheartj/ehac521https://hdl.handle.net/20.500.14352/99915Background It remains unknown whether the presence of coronary microcirculatory dysfunction (CMD) correlates with its equivalent conditionin the brain, cerebral small vessel disease (CSVD). The cerebral-coronary connection (C3), a prospective blinded study, investigatedthe prevalence of CMD in patients with coronary artery disease (CAD) and its association with CSVD and cognitive function. Methodsand results Patients with documented CAD fulfilling inclusion criteria underwent physiological assessment of epicardial vessels and the microcirculation using intracoronary pressure and Doppler. Coronary microcirculation-related indices included coronary flow reserve (CFR) and hyperaemic microvascular resistance. Brain magnetic resonance imaging, transcranial Doppler (TCD), and neurocognitive examination were performed. Overall, 67 patients were included in the study (mean age 66 years, 73% female). Patients with abnormal CFR (<2.0) (55.2%) showed higher burden of white-matter hyperintensities: 43.2 vs. 20.0% (P=0.044). After statistical adjustment, low CFR was associated with lower grey matter volume (P=0.024) and with parameters of white-matter microstructural damage in diffusion-tensor imaging (lower fractional anisotropy and higher mean diffusivity, P=0.029 and P=0.032, respectively). Low CFR was associated with higher resistive (P=0.027) and pulsatility (P=0.043) values on TCD, and worse neurocognitive test scores (lower mini mental state examination, P=0.025, and slower Trail Making Test A, P=0.034). Conclusions Coronary microcirculatory dysfunction is frequent in patients with CAD and correlates with CSVD, abnormal cerebral flow haemodynamics, and significant cognitive impairment. These findings support the hypothesis that microvascular dysfunction in the heart and the brain are part of a single pathological process affecting microcirculation in patients with CAD.engAttribution-NonCommercial-NoDerivatives 4.0 Internationaljournal articlehttps//doi.org/10.1093/eurheartj/ehac521open accessMedicina3201 Ciencias Clínicas