Association between coronary dominance pattern and left ventricular mass index: Is there a gender disparity?

Abstract

Increased left ventricular mass (LVM), LVM index (LVMI) and left ventricular hypertrophy (LVH) are significantly associated with a higher incidence of clinical events including death. 1 Also, although increased LVMI and LVH may be associated with traditional cardiovascular risk factors, the presence of LVH predicts adverse cardiovascular events independent of underlying cardiovascular disease and risk factors. 1,2 However, the association of coronary anatomical parameters with LVM and LVMI remains unclear.Coronary artery dominance defines the anatomical variations in the coronary circulation. While right dominance (RD) is the most prevalent coronary circulation pattern in the general population and is seen in approximately 70%-80% of the population, co-dominance (CD) and left dominance (LD) patterns are seen in approximately 10%-20% and 10% of the population, respectively. 3 Although

Clinical Significance of Coronary Arterial Dominance: A Review of the Literature

“…Coronary dominance appears to be an independent risk factor for the development of left ventricular hypertrophy, with those of left and codominant patterns exhibiting higher rates of hypertrophy, particularly in women. 90 Unequal hypertrophy patterns between left and right may also be represented in the QRS axis between the 2 groups such that left coronary dominance tends to deviate more leftward. 91 …”

Gender-Related Variations in the Cardiac Structure and Cardiovascular Physiology

“…[3][4][5] Moreover, the impact of coronary dominance pattern on myocardial flow reserve and left ventricular mass may vary significantly between genders and may be independently associated with prognosis. 6 Since the majority of patients in the PCI groups in the study by Daoulah et al 1 had been treated with bifurcation stenting that affects the blood supply of entire left coronary circulation, it would be worth knowing if the coronary dominance pattern had a gender-based impact on CV outcomes in these patients. Additionally, all procedural factors that may affect CV outcomes such as stent diameter, total stent length, bifurcation stenting technique, post-procedural myocardial flow and blushing, usage of advanced imaging methods and bailout strategies should be clearly discussed in patients undergoing complex PCI procedures.…”