Evidence map›Paper›PMID 42348298›Full record

Observational studyBrain and behavior2026

The "Brain's Traffic Map" Reveals Neural Pathways Linked to Coronary Microvascular Dysfunction in Women.

Arzu C Has Silemek, Jeffrey C Wertheimer, Janet Wei, Yibin Xie, Mitzi Gonzales, Debiao Li, Oana Dumitrascu, Sarah Kremen, Zaldy S Tan, Micheal D Nelson and 3 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03876223 (Women's Ischemia Syndrome Evaluation), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03876223 recruitingnot on this map

Women's Ischemia Syndrome Evaluation (WISE) Mechanisms of Coronary Microvascular Dysfunction Leading to Pre-Heart Failure With Preserved Ejection Fraction (HFpEF)

TypeobservationalSponsorCedars-Sinai Medical CenterRan2019 to 2027Enrolled180ConditionsCoronary Microvascular Dysfunction, Heart Failure With Preserved Ejection Fraction (HFpEF)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Arzu C Has SilemekDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0003-4609-0956
Jeffrey C WertheimerDepartment of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0009-0002-0858-4234
Janet WeiBarbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-1311-618X
Yibin XieDepartment of Biomedical Sciences and Imaging, Biomedical Imaging Research Institute (BIRI), Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-0333-567X
Mitzi GonzalesDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-8467-0938
Debiao LiDepartment of Biomedical Sciences and Imaging, Biomedical Imaging Research Institute (BIRI), Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-8560-8231
Oana DumitrascuDepartment of Neurology, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona, USA.ORCID https://orcid.org/0000-0002-1031-9184
Sarah KremenDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0003-2593-0602
Zaldy S TanDepartments of Neurology and Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-4588-1206
Micheal D NelsonBarbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-3232-8639
C Noel Bairey MerzBarbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-9933-5155
Pascal SatiDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-6763-0125
Wei GaoDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-9260-2601

Funding

ZONA-FREE HAMSTER OVA ASSAY AS AN INDICATOR OF MALE FERTILITYM01RR000425 · NCRR · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI ANDERSON, GAIL V · 1985 to 2011
$74.2M
UCLA Clinical and Translational Science InstituteUL1TR000124 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$57.0M
The Microvascular Aging and Eicosanoids - Women's Evaluation of Systemic Aging Tenacity (MAE-WEST) ("You are never too old to become younger!") Specialized Center for Research Excellence (SCORE)U54AG065141 · NIA · CEDARS-SINAI MEDICAL CENTER · PI BAIREY MERZ, CATHLEEN NOEL, CHENG, SUSAN · 2020 to 2024
$8.7M
The Microvascular Aging Effects - Women's Evaluation of Systemic aging Tenacity in Heart, Brain and Frailty (MAE-WEST HBF) ("You are never too old to become younger!")U54AG094168 · NIA · CEDARS-SINAI MEDICAL CENTER · PI chi-hong tseng · 2025 to 2026
$4.5M
Women's Ischemia Syndrome Evaluation (WISE) - Mechanisms of Coronary Microvascular Dysfunction Leading to Pre-Heart Failure with Preserved Ejection Fraction (HFpEF)R01HL146158 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI BAIREY MERZ, CATHLEEN NOEL · 2019 to 2023
$3.7M
Women's Ischemia Syndrome Evaluation (WISE) Coronary Vascular DysfunctionR01HL090957 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI BAIREY MERZ, CATHLEEN NOEL, PEPINE, CARL J · 2008 to 2013
$3.5M
Whole-Heart Myocardial Blood Flow Quantification Using MRIR01HL124649 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI LI, DEBIAO · 2015 to 2018
$3.3M
Behavioral Medicine and Cardiovascular Research TrainingT32HL069751 · NHLBI · HENRY M. JACKSON FDN FOR THE ADV MIL/MED · PI KRANTZ, DAVID S. · 2003 to 2007
$1.2M
Atherosclerosis, Immune Mediated Inflammation and Hypoestrogenemia in Young WomenK23HL127262 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI SHUFELT, CHRISANDRA LEE · 2016 to 2020
$988k
Magnetic Resonance Imaging for Global Atherosclerosis Risk AssessmentK23HL125941 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI WEI, JANET · 2016 to 2020
$985k
Cardiac Autonomic Function in WomenK23HL105787 · NHLBI · EMORY UNIVERSITY · PI MEHTA, PUJA KIRAN · 2012 to 2016
$813k
Hypertensive Disorders of Pregnancy: Pathways to Future Cardiovascular DiseaseK23HL151867 · NHLBI · THE CHRIST HOSPITAL · PI QUESADA, ODAYME · 2020 to 2024
$799k
Adelson Family Foundation, Cedars-Sinai Medical CenterBarbra Streisand Women's Cardiovascular Research and Education Program, Cedars-Sinai Medical CenterEdythe L. Broad and the Constance Austin Women's Heart Research Fellowships, Cedars-Sinai Medical CenterErika Glazer Women's Heart Health ProjectLinda Joy Pollin Women's Heart Health ProgramNational Heart, Lung and Blood Institutes 1R03 AG032631National Heart, Lung and Blood Institutes K23HL151867 T32 HL69751National Heart, Lung and Blood Institutes MO1-RR00425National Heart, Lung and Blood Institutes N01-HV-68161National Heart, Lung and Blood Institutes N01-HV-68162National Heart, Lung and Blood Institutes N01-HV-68163National Heart, Lung and Blood Institutes N01-HV-68164National Heart, Lung and Blood Institutes PR150224P1 (CDMRP-DoD)National Heart, Lung and Blood Institutes R01HL124649National Heart, Lung and Blood Institutes U0164829National Heart, Lung and Blood Institutes U01 HL649141National Heart, Lung and Blood Institutes U01 HL649241National Heart, Lung and Blood Institutes U54AG065141National Heart, Lung and Blood Institutes U54AG094168NCATS NIH HHS UL1 TR000124NCRR NIH HHS M01 RR000425NHLBI NIH HHS K23 HL105787NHLBI NIH HHS K23 HL125941NHLBI NIH HHS K23 HL127262NHLBI NIH HHS K23 HL151867NHLBI NIH HHS R01 HL090957NHLBI NIH HHS R01 HL124649NHLBI NIH HHS R01 HL146158NHLBI NIH HHS T32 HL069751NHLBI NIH HHS UL1TR000124NIA NIH HHS R03 AG032631NIA NIH HHS U54 AG065141NIA NIH HHS U54 AG094168
6 · The paper itself

Abstract

backgroundThe brain-heart axis is central to vascular health, yet no imaging biomarkers capture integrated dysfunction across neural and coronary microvascular networks. Although coronary microvascular dysfunction links to cognitive decline, neural correlates connecting cerebral efficiency with coronary physiology remain unclear.

objectivesTo determine whether the Unified Structural and Functional Connectivity (USFC)-a multimodal magnetic resonance imaging (MRI) "traffic map" of brain network efficiency-predicts coronary endothelial function and cognition in women with ischemia and no obstructive coronary artery disease (INOCA).

methodsThirty-three women with suspected INOCA from the Women's Ischemia Syndrome Evaluation (WISE) study (NCT03876223) underwent invasive coronary function testing, cardiac MRI, cognitive evaluation, and multimodal brain MRI. USFC, structural connectivity (SC), and functional connectivity (FC) were computed for predefined 10 backbone pathways. Support vector regression and logistic classification assessed predictive performance.

resultsUSFC explained 16%-20% more variance in coronary endothelial function, myocardial perfusion reserve, and cognition than SC or FC alone (p < 0.05). Connectivity between the left caudate-superior medial orbital gyrus and right calcarine-inferior occipital gyrus emerged as robust predictors of crystallized cognition (r = -0.78, p

conclusionsUSFC identifies neuro-cardiac pathways linking cerebral efficiency with coronary endothelial function. These results introduce a sensitive biomarker of systemic vulnerability, highlighting occipital and frontostriatal pathways as shared substrates of dysfunction. USFC offers a mechanistic framework for detecting vascular risk across metabolically demanding tissues.

trial registrationClinicalTrials.gov identifier: NCT03876223.

Indexed as

BrainCoronary Artery DiseaseAgedCognitionFemaleHumansMagnetic Resonance ImagingMicrovesselsMiddle AgedNeural Pathwaysbrain–heart axiscognitioncoronary microvascular dysfunctionneuroimagingUnified Structural and Functional Connectivitywomen's cardiovascular health

Identifiers

PMID42348298
PMCPMC13296822

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.