Sex-dependent association between coronary vessel dominance and cardiac syndrome X: a case-control study

Makarović, Zorin; Makarović, Sandra; Bilić-Ćurčić, Ines

doi:10.1186/1471-2261-14-142

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…The pattern of coronary artery dominance was diagnosed according to whether the PDA originates from the RCA, LCx, or both sides, using CAG or computed tomography coronary angiography [26]. The proportion of right, left, and balanced dominance has been reported to be 70–86%, 8–13%, and 4–18%, respectively [8, 25, 27, 28]. In the present study, right dominance (94.0% vs. 87.9%), left dominance (4.5% vs. 8.1%), and co-dominance (1.5% vs. 4.0%) were statistically different between patients with acute inferior MI and the controls.…”

Section: Discussionmentioning

confidence: 99%

Association between coronary dominance and acute inferior myocardial infarction: a matched, case-control study

Wang

Gao

et al. 2019

BMC Cardiovasc Disord

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BackgroundPrevious studies have found a connection between left coronary artery dominance and worse prognoses in patient with acute coronary syndrome, which remains a predominant cause of morbidity and mortality globally. The aim of this study was to investigate whether coronary dominance is associated with the incidence of acute inferior myocardial infarction (MI).MethodsBetween January 2011 and November 2014, 265 patients with acute inferior MI and 530 age-matched and sex-matched controls were recruited for a case-control study in the Second Affiliated Hospital of Xi’an Jiaotong University in Xi’an, China. All participants underwent coronary angiography. The exclusion criteria included history of coronary artery bypass graft surgery, chronic or systemic diseases (including hepatic failure, kidney failure, hypothyroidism and Grave’s disease), ventricular fibrillation, and known allergy to iodinated contrast agent. Patients with left- or co-dominant anatomies were placed into the LD group and those with right-dominant anatomy were included in the RD group. The association of acute inferior MI and coronary dominant anatomy were assessed using multivariable conditional logistic regression, and to estimate the odds ratio (OR) and 95% confidence interval (95%CI).ResultsDistributions of right dominance were significantly different between the acute inferior MI group and control group (94.0% vs. 87.9%, P = 0.018). Univariable conditional logistic regression revealed that right dominance may be a risk factor for the incident acute inferior MI (OR: 2.137; 95% CI: 1.210–3.776; P = 0.009). After adjusting for baseline systolic blood pressure, heart rate, smoking status, diabetes mellitus, hypertension, hyperlipidaemia, and family history of coronary artery disease, results of multivariate conditional logistic regression showed that right dominance was associated with the incidence of acute inferior MI (OR: 2.396; 95% CI: 1.328–4.321; P = 0.004).ConclusionsRight coronary dominance may play a disadvantageous role in the incidence of acute inferior MI. However, further studies are needed to verify our findings, especially with regard to the underlying mechanisms.

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Section: Discussionmentioning

confidence: 99%

Association between coronary dominance and acute inferior myocardial infarction: a matched, case-control study

Wang

Gao

et al. 2019

BMC Cardiovasc Disord

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“…Bizim çalışmamızda cinsiyet ile el tercihi arasında anlamlı ilişki saptanmamıştır. Koroner dominans ve cinsiyet arasında diğer çalışmalardakine benzer olarak bizim çalışmamımzda da istatiksel olarak anlamlı bir ilişki yoktur (16).…”

Section: Bulgularunclassified

El dominansı ve koroner dominans arası ilişki

Tolunay¹

2019

Turkish Journal of Clinics and Laboratory

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Amaç: Koroner arter hastalığının bilinen risk faktörlerinin dışında, koroner dominans, ektazi, bifürkasyon açısı gibi anatomik risk faktörleride mevcuttur. Fonksiyonel bir serebral lateralizasyon olarak kabul edilen el dominansının bazı hastalıklarla ilişkisi daha önce tanımlanmıştır. Bu çalışmanın amacı genetik faktörler ile belirlenen el dominansı ve koroner dominans arası ilişkiyi tanımlamaktır. Gereç ve Yöntemler: Polikliniğe başvuran, koroner anjiyografi uygulanmış 226 hastanın koroner anjiyografileri değerlendirildi. Hastalar sağ koroner dominant, sol dominant ve dengeli dominant olarak gruplandırıldı. Hastaların el tercihlerini belirlemek için "Oldfield Anketi" kullanıldı. Hastalar sağ el baskın, sol el baskın ve her iki elde baskınlık olarak üç gruba ayrıldı. Koroner dominans ve el dominansı arasındaki ilişki araştırıldı. Bulgular: Anjiyografisi yapılan 226 hastanın 96'sı (%42,5) kadın, 130' u (%57,5) erkekti. 170 hasta (%75, 2) sağ el, 14 hasta sol el (%6,2) ve 42 hasta (%18,6) her iki el baskınlığına sahipti. 160 hastada sağ koroner dominans (%70, 8), 26 hastada sol koroner dominans (%11,5) ve 40 hastada (%17,7) dengeli koroner dominans belirlenmiştir. El dominansı ile cinsiyet arasında istatiksel olarak anlamlı fark bulunamamıştır (p: 0,309). Koroner dominans ve cinsiyet arası anlamlı bir ilişki saptanmamıştır (p:0,114). Koroner arter dominansı ile serebral fonksiyonel dominans arasında istatistiksel olarak anlamlı bir ilişki vardır (p: 0,005). Sonuç: Çalışmamızda koroner arter dominansı ve serebral fonksiyonel dominans arasında istatistiksel olarak anlamlı bir ilişki saptanmıştır. Ancak serebral ve koroner dominansı anatomik düzeyde karşılaştırmak için dominant hemisferi daha net olarak gösteren invaziv bir test olan wada testi ile yapılacak ileri çalışmalara ve anatomik lateralizasyonu karşılaştıran kadavra çalışmalarına ihtiyaç vardır.

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“…Based on the results of our recently published research ( 24 ), we propose a new mechanism that could be added to endothelial independent mechanisms within the ischemic hypothesis on the development of non-CAD. Alongside the known endothelial independent pathophysiological mechanisms such as aortic pressure, myocardial contractility, myocardial metabolism and neurohumoral factors ( 25 ), another possible contributor would be the type of coronary supply, specifically the left type of dominance (particularly in women), and absence of mixed type in men ( 24 ).…”

Section: Nonobstructive Coronary Artery Disease – Pathophysiological mentioning

confidence: 99%

“…Non-ischemic hypothesis explains the CSX phenomenon and non-CAD because of altered pain perception ( 25 ). Previous studies demonstrated that patients with angina and normal coronary arteries had enhanced pain perception to heat and electrical stimuli ( 26 ).…”

Section: Nonobstructive Coronary Artery Disease – Pathophysiological mentioning

confidence: 99%

“…To confirm non-ischemic origin of the disorder (altered pain perception), MIBG scintigraphy of sympathetic heart innervation for visualizing afferent dysfunction and direct heart stimulation with dobutamine or electrostimulator for demonstrating efferent dysfunction can be performed ( 25 ). Additional tests are also available such as insufficiently standardized psychological tests for establishing habitual component of disorder, as well as absence of adaptation to repeated pain stimuli ( 27 ).…”

Section: Diagnosis Of Nonobstructive Coronary Artery Diseasementioning

confidence: 99%

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Nonobstructive Coronary Artery Disease – Clinical Relevance, Diagnosis, Management and Proposal of New Pathophysiological Classification

Makarović

2018

ACC

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SUMMARY – New data gathered from large clinical trials indicate that nonobstructive coronary artery disease (non-CAD) is a clinical entity that should not be ignored. It is estimated that 50% of female population undergoing coronarography are diagnosed with non-CAD. There is also an increase in the prevalence of non-CAD in both genders, which is probably due to gradual expanding of clinical indications for angiography in patients with angina. Furthermore, considering the increased mortality risk established recently, a prognosis of non-CAD is not benign as previously thought. However, the concept and definition of non-CAD remains elusive causing difficulties in diagnosis and treatment. One of the major shortcomings is the exclusion-based diagnosis of non-CAD. Furthermore, treatment of non-CAD still presents a great challenge and optimal therapy is yet to be determined. There are two major hypotheses explaining the pathophysiological mechanisms of non-CAD, i.e. ischemic hypothesis based on abnormal microvascular dysfunction and non-ischemic one based on altered pain perception. This review encompasses a broader spectrum of pathophysiological mechanisms of non-CAD, and proposes a new way of classification based on the major disorder involved: type I (ischemic mechanisms) and type II (non-ischemic mechanisms), depending on which mechanism predominates. Hopefully, this would provide new insights in the understanding of this disorder, thus leading to accurate and early diagnosis and successful treatment, especially considering the increased mortality risk in these patients.

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Sex-dependent association between coronary vessel dominance and cardiac syndrome X: a case-control study

Cited by 8 publications

References 24 publications

Association between coronary dominance and acute inferior myocardial infarction: a matched, case-control study

Association between coronary dominance and acute inferior myocardial infarction: a matched, case-control study

El dominansı ve koroner dominans arası ilişki

Nonobstructive Coronary Artery Disease – Clinical Relevance, Diagnosis, Management and Proposal of New Pathophysiological Classification

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