Abstract #4213

Functional Connectivity Mediates the Impact of Iron Content on Cognition in Women with Suspected Coronary Microvascular Dysfunction

Arzu C Has Silemek^1,2, Jeffrey Wertheimer³, Janet Wei ⁴, Oana Dumitrascu⁵, Sarah Kremen¹, Yibin Xie², Debiao Li², Michael D Nelson⁶, Zaldy S Tan⁷, Noel Bairey Merz⁴, Pascal Sati^1,2, and Wei Gao²

¹Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²Department of Biomedical Sciences and Imaging, Biomedical Imaging Research Institute (BIRI), Cedars-Sinai Medical Center, Los Angeles, CA, United States, ³Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁴Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁵Department of Neurology, Mayo Clinic College of Medicine and Science, Scottsdale, AZ, United States, ⁶Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States, ⁷Departments of Neurology and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States

Synopsis

Keywords: Aging, Heart, Brain, Iron, Cognition, fMRI, women with INOCA, high resolution QSM Aging, Dementia

Motivation: Women with ischemia and non-obstructive coronary arteries (INOCA) may experience cognitive decline due to non-heme iron accumulation causing oxidative stress and cell death, but underlying mechanism is still unknown.

Goal(s): This study aims to understand how iron affects brain function and cognitive performance in women with suspected INOCA.

Approach: By combining high-resolution Quantitative Susceptibility Mapping and resting-state fMRI, the research focused on thalamic iron and its association with brain connectivity and cognitive metrics.

Results: Results indicated that thalamic iron impacts cognitive outcomes, particularly executive functions and processing speed, in women with suspected INOCA, with these effects partly mediated by changes in functional connectivity.

Impact: This study's insights into iron's cognitive effects may guide early interventions, influence therapeutic strategies for INOCA patients, and prompt further research into the systemic impact of iron on brain connectivity and cognitive health.

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