The association between coronary arterial dominancy and extent of coronary artery disease in angiography and paraclinical studies

Abstract

The association between coronary arterial dominance patterns and the coronary artery diameter, length, and valvular heart diseases were previously studied. However, its association with coronary artery disease (CAD) is unclear. We investigated to determine whether the extent and localization of CAD differ in right, left, or codominant coronary arterial patterns. Twelve thousand five hundred fifty-eight patients admitted to Tehran Heart Center for coronary angiography were studied retrospectively (2004-2006). The extent and localization of CAD and the dominant artery were determined. There were 62.7% males. The mean age was 57.6 +/- 10.3. 84.2% [95% confidence interval (CI); 83.6-84.8%], 10.9% (95% CI; 10.4-11.4%), and 4.8% (95% CI; 4.4-5.2%) of the patients were right, left, and codominant, respectively; No significant difference considering age, sex, positive family history, hypertension, hyperlipidemia, electrocardiography, exercise treadmill stress test, and perfusion scan were seen in the groups. The right-dominant patients tend to have three-vessel disease (33.1% vs. 27%, P < 0.0001), stenosis of more than 50% in right coronary artery (65.9% vs. 57.9%, P < 0.0001) and left circumflex territories (64% vs. 59.4%, P = 0.01), more than the left-dominant patients. The involvements of the left main coronary artery, left anterior descending artery territory, and posterior descending artery were not significantly different. This study demonstrates a relationship between angiographic CAD severity, and the involved arterial territory and dominancy patterns.

Prognostic value of coronary vessel dominance in relation to significant coronary artery disease determined with non-invasive computed tomography coronary angiography

“…20 Similar findings were shown in the study by Vasheghani-Farahani et al, identifying a higher prevalance of three-vessel disease in patients with a right dominant coronary artery system. 24 However, Balci et al did not find a significant difference in the extent of significant CAD between patients with a right and left dominant coronary artery system. 25 Although the current study did not reveal significant differences in the distribution of significant CAD on CTA, normal CTA results or wall irregularities causing ,30% luminal narrowing were observed less frequently in patients with a right dominant coronary artery system compared with patients with left dominant and balanced coronary artery systems.…”

Impact of Coronary Dominance on In-Hospital Outcomes after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome

“…In the majority of patients, the right coronary artery (RCA) reaches the crux of the heart and supplies the posterior descending artery (PDA) [1]. Left-dominant (LD) anatomy, described as a variant of normal anatomy, has a prevalence of approximately 5–12% in the general population [2]–[5]. In these individuals, the left circumflex artery (LCX) reaches the crux and supplies the posterior descending and, usually, the atrioventricular nodal branches [2].…”

Impact of Coronary CT Angiography on Surgical Decision-Making for Coronary Artery Bypass Graft Surgery

“…Our goal was to identify patients in each of the three categories: normal coronary arteries (no stenosis); mild CAD (nonhemodynamically significant, less than 70% stenosis in any coronary segment or less than 50% stenosis in the left main coronary artery by CCA); and significant CAD ($70% of stenosis in one or more of the major coronary arteries by CCA) (17). The major coronary arteries scored included the left anterior descending artery or diagonal artery, the left circumflex artery or obtuse marginal artery or left posterior lateral branch, the right coronary artery or right posterior descending artery or right posterior lateral branch segment, and the left main coronary artery (18).…”