open access

Vol 82, No 1 (2023)
Original article
Submitted: 2021-10-23
Accepted: 2021-11-28
Published online: 2022-01-17
Get Citation

A study of coronary dominance and its clinical significance

D. P. Aricatt1, A. Prabhu2, R. Avadhani1, K Subramanyam3, A. S. Manzil4, J. Ezhilan5, R. Das6
·
Pubmed: 35099044
·
Folia Morphol 2023;82(1):102-107.
Affiliations
  1. Department of Anatomy, Yenepoya Medical College, Yenepoya University Deralakatte, Mangalore, Karnataka, India
  2. Yenepoya Research Centre, Yenepoya University Deralakatte, Mangalore, Karnataka, India
  3. Department of Interventional Cardiology, K.S. Hegde Medical Academy Hospital, Mangalore, Karnataka, India
  4. Department of CardioVascular Sciences, Sahakarana Hrudayalaya, Government Medical College Pariyaram, Kannur, Kerala, India
  5. Department of Cardiology, Madras Medical Mission, Chennai, Tamilnadu, India
  6. Division of Data Analytics, Bioinformatics and Structural Biology (DABS), Mangalore, Karnataka, India

open access

Vol 82, No 1 (2023)
ORIGINAL ARTICLES
Submitted: 2021-10-23
Accepted: 2021-11-28
Published online: 2022-01-17

Abstract

Background: Coronary artery disease is the most common cause of morbidity and mortality especially in the developing countries. The aim of the study was to find out cardiac dominance percentages and its association with coronary artery stenosis among each pattern of dominance. The objectives were to assess coronary vessel morphology of patients within each pattern of dominance, to find if gender differences exist among dominance patterns and also to find the distribution percentages of stenosis among dominance patterns.
Materials and methods: Four thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the pre-selected hospitals from four states of South India. Informed consents were obtained. Post coronary artery bypass grafting, post percutaneous coronary intervention patients and patient being diabetic for ≥ 5 years were excluded from the study.
Results: Right cardiac dominance was seen in 85.5%, left in 9.7%, and co-dominant in 4.8% cases. The percentages of dominance were almost similar among both genders except for left dominance which were higher among male samples. The diameter of right coronary artery and left circumflex coronary artery coronary arteries were significantly associated with dominance patterns. The prevalence of stenosis was more for left dominance patterns, followed by right dominance patterns and least for co-dominant patterns.
Conclusions: There is a necessity to see association between dominance patterns with the coronary artery disease which can help the interventional cardiologists. The disease patterns in the present study were predominantly in the left dominant or in the co-dominant hearts.

Abstract

Background: Coronary artery disease is the most common cause of morbidity and mortality especially in the developing countries. The aim of the study was to find out cardiac dominance percentages and its association with coronary artery stenosis among each pattern of dominance. The objectives were to assess coronary vessel morphology of patients within each pattern of dominance, to find if gender differences exist among dominance patterns and also to find the distribution percentages of stenosis among dominance patterns.
Materials and methods: Four thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the pre-selected hospitals from four states of South India. Informed consents were obtained. Post coronary artery bypass grafting, post percutaneous coronary intervention patients and patient being diabetic for ≥ 5 years were excluded from the study.
Results: Right cardiac dominance was seen in 85.5%, left in 9.7%, and co-dominant in 4.8% cases. The percentages of dominance were almost similar among both genders except for left dominance which were higher among male samples. The diameter of right coronary artery and left circumflex coronary artery coronary arteries were significantly associated with dominance patterns. The prevalence of stenosis was more for left dominance patterns, followed by right dominance patterns and least for co-dominant patterns.
Conclusions: There is a necessity to see association between dominance patterns with the coronary artery disease which can help the interventional cardiologists. The disease patterns in the present study were predominantly in the left dominant or in the co-dominant hearts.

Get Citation

Keywords

cardiac dominance, coronary vessel morphology, coronary artery disease

About this article
Title

A study of coronary dominance and its clinical significance

Journal

Folia Morphologica

Issue

Vol 82, No 1 (2023)

Article type

Original article

Pages

102-107

Published online

2022-01-17

Page views

3811

Article views/downloads

3106

DOI

10.5603/FM.a2022.0005

Pubmed

35099044

Bibliographic record

Folia Morphol 2023;82(1):102-107.

Keywords

cardiac dominance
coronary vessel morphology
coronary artery disease

Authors

D. P. Aricatt
A. Prabhu
R. Avadhani
K Subramanyam
A. S. Manzil
J. Ezhilan
R. Das

References (28)
  1. Adil M, Nadeem M, Hafizullah M, et al. Comparison of left coronary artery diameter among diabetics and non-diabetics. J Postgrad Med Inst (Peshawar-Pakistan). 2012; 26(4): 369–376.
  2. Altin C, Kanyilmaz S, Koc S, et al. Coronary anatomy, anatomic variations and anomalies: a retrospective coronary angiography study. Singapore Med J. 2015; 56(6): 339–345.
  3. Amin K, Javed M, Mehmood A, et al. Acute inferior wall myocardial infarction: Frequency of AV blocks. TPMJ. 2004; 11(1): 31–37.
  4. Azad N, Lemay G. Management of chronic heart failure in the older population. J Geriatr Cardiol. 2014; 11(4): 329–337.
  5. Bordoloi R. An anatomical study of coronary artery dominance in human cadaveric hearts. J Evid Based Med Healthcare. 2016; 3(103): 5695–5699.
  6. Cademartiri F, Malagò R, La Grutta L, et al. Coronary variants and anomalies: methodology of visualisation with 64-slice CT and prevalence in 202 consecutive patients. Radiol Med. 2007; 112(8): 1117–1131.
  7. Dhakal A, Shrestha R, Maskey A, et al. Coronary artery dimensions in the Nepalese population. JASI. 2015; 64(1): 27–31.
  8. Elangovan C, Jaganathan V, Alageshan R, et al. Clinical and anthropometric correlation of normal Coronary artery dimensions. Indian Heart J. 2005; 57(5): 381–425.
  9. Gebhard C, Fuchs TA, Stehli J, et al. Coronary dominance and prognosis in patients undergoing coronary computed tomographic angiography: results from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry. Eur Heart J Cardiovasc Imaging. 2015; 16(8): 853–862.
  10. Gebhard C, Gick M, Ferenc M, et al. Coronary dominance and prognosis in patients with chronic total occlusion treated with percutaneous coronary intervention. Catheter Cardiovasc Interv. 2018; 91(4): 669–678.
  11. Ghaffari S, Kazemi B, Dadashzadeh J, et al. The relation between left coronary dominancy and atheroscleroticinvolvement of left anterior descending artery origin. J Cardiovasc Thorac Res. 2013; 5(1): 1–4.
  12. Goldberg A, Southern DA, Galbraith PD, et al. Coronary dominance and prognosis of patients with acute coronary syndrome. Am Heart J. 2007; 154(6): 1116–1122.
  13. Helft G, Dambrin G, Zaman A, et al. Percutaneous coronary intervention in anticoagulated patients via radial artery access. Catheter Cardiovasc Interv. 2009; 73(1): 44–47.
  14. Hermiller JB, Cusma JT, Spero LA, et al. Quantitative and qualitative coronary angiographic analysis: review of methods, utility, and limitations. Cathet Cardiovasc Diagn. 1992; 25(2): 110–131.
  15. Jeffrey JP, Scott K, and De. Coronary arteriography and Intra coronary Imaging. In: Mann DL, Zipes DP, Libby P, Bonow RO. Braunwald's heart disease: a textbook of cardiovascular medicine. Part 1. Elsevier Health Sciences 2017: 392–428.
  16. Kim E, Yoo J, Cheon W, et al. Coronary artery size in Korean: normal value and its determinants. Korean Circ J. 2005; 35(2): 115.
  17. Koşar P, Ergun E, Oztürk C, et al. Anatomic variations and anomalies of the coronary arteries: 64-slice CT angiographic appearance. Diagn Interv Radiol. 2009; 15(4): 275–283.
  18. Lam MK, Tandjung K, Sen H, et al. Coronary artery dominance and the risk of adverse clinical events following percutaneous coronary intervention: insights from the prospective, randomised TWENTE trial. EuroIntervention. 2015; 11(2): 180–187.
  19. MacAlpin RN, Abbasi AS, Grollman JH, et al. Human coronary artery size during life. A cinearteriographic study. Radiology. 1973; 108(3): 567–576.
  20. Moore KL, Dalley AF, Agur AM. Clinically oriented anatomy. Lippincott Williams & Wilkins 2013: 151–174.
  21. Mowatt G, Cummins E, Waugh N, et al. Systematic review of the clinical effectiveness and cost-effectiveness of 64-slice or higher computed tomography angiography as an alternative to invasive coronary angiography in the investigation of coronary artery disease. Health Technol Assess. 2008; 12(17): iii–iv, ix.
  22. Paudel N, Jha GS, Alurkar VM, et al. Coronary dominance and predictors of adverse events during coronary interventional procedures: an observational study. J Adv Intern Med. 2017; 6(1): 4–8.
  23. Paul A, Avadhani R, Subramanyam K. Anomalous origins and branching patterns in coronary arteries: an angiographic prevalence study. JASI. 2016; 65(2): 136–142.
  24. Reagan K, Boxt LM, Katz J. Introduction to coronary arteriography. Radiol Clin North Am. 1994; 32(3): 419–433.
  25. Reddy V, Lokanadham S. Coronary dominance in south Indian population. Int J Med Res Health Sci. 2013; 2(1): 78–82.
  26. Shukri IG, Hawas JM, Karim SH, et al. Angiographic study of the normal coronary artery in patients attending Ulaimani Center for Heart Diseases. ESJ. 2014; 10(24): 384–415.
  27. Standring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC. Gray's Anatomy. 41 stedn. Churchill Livingstone, London 2008: 978–980.
  28. Vasheghani-Farahani A, Kassaian SE, Yaminisharif A, et al. The association between coronary arterial dominancy and extent of coronary artery disease in angiography and paraclinical studies. Clin Anat. 2008; 21(6): 519–523.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl