The Relation between Left Coronary Dominancy and Atherosclerotic Involvement of Left Anterior Descending Artery Origin

Ghaffari, Samad; Kazemi, Babak; Dadashzadeh, Jalil; Sepehri, Bita

doi:10.5681/jcvtr.2013.001

Cited by 3 publications

(2 citation statements)

References 125 publications

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“… 38 , 39 , 40 In left‐dominant systems, >90% of the coronary blood flow enters the left coronary artery, which can cause high shear stress at the bifurcation of the left main artery. 41 , 42 The PDA, a significant anatomic variation defining coronary dominance, exhibits a greater angle of takeoff in left‐dominant hearts compared with right‐dominant systems. 43 , 44 Overall, coronary artery lumen sizes were observed to be larger within the respective dominant coronary system, with differences more pronounced within distal branches.…”

Section: Difference In Coronary Flow Of Left and Right Dominant Coron...mentioning

confidence: 99%

“…Difference in coronary flow has been associated with greater prevalence of coronary disease in the LAD in individuals with left coronary dominance 3 , 9 , 41 due to both increased flow volume and longer LADs in left‐dominant systems. 72 Left coronary dominance has also been associated with increased prevalence of myocardial bridges particularly within the left coronary system and LAD, 73 , 74 possibly increasing risk for nonatherosclerotic obstructive disease.…”

Section: Clinical Relevance and Disease Risk Associated With Coronary...mentioning

confidence: 99%

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

Wu,

Kheiwa,

Swamy

et al. 2024

JAHA

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Coronary dominance describes the anatomic variation of coronary arterial supply, notably as it relates to perfusion of the inferior cardiac territories. Differences in the development and outcome in select disease states between coronary dominance patterns are increasingly recognized. In particular, observational studies have identified higher prevalence of poor outcomes in left coronary dominance in the setting of ischemic, conduction, and valvular disease. In this qualitative literature review, we summarize anatomic, physiologic, and clinical implications of differences in coronary dominance to highlight current understanding and gaps in the literature that should warrant further studies.

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Section: Difference In Coronary Flow Of Left and Right Dominant Coron...mentioning

confidence: 99%

Section: Clinical Relevance and Disease Risk Associated With Coronary...mentioning

confidence: 99%

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

Wu,

Kheiwa,

Swamy

et al. 2024

JAHA

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Variations of The Coronary Arteries in The Population of Sohag Governorate

Abdelrahman¹

2020

Sohag Medical Journal

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Association of coronary artery dominance and mortality rate and complications in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

et al. 2020

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Background: Percutaneous coronary intervention (PCI) is the treatment of choice for patients with ST-segment elevation myocardial infarction (STEMI). Effect of coronary artery dominance on the patients' outcome following primary PCI (PPCI) is not fully investigated. We investigated the association of coronary artery dominance with complications and 1-year mortality rate of PPCI. Materials and Methods: In this retrospective study, patients with STEMI treated with PPCI from March 2016 to February 2018 were divided into three groups based on their coronary dominancy: left dominance (LD), right dominance (RD), and codominant. Demographic characteristics, medical history, results of physical examination, electrocardiography, angiography, and echocardiography were compared between the groups. Results: Of 491 patients included in this study, 34 patients (7%) were LD and 22 patients (4.5%) were codominant. Accordingly, 54 propensity-matched RD patients were included in the analysis. The demographics and comorbidities of the three groups were not different ( P > 0.05); however, all patients in the RD group had thrombolysis in myocardial infarction (TIMI) 3, while five patients in the LD and five patients in the codominant group had a TIMI ≤2 ( P = 0.006). At admission, the median left ventricular ejection fraction (LVEF) was highest in RD patients and lowest in LD and codominant patients (34%, P = 0.009). There was no difference in terms of success or complications of PCI, in-hospital, and 1-year mortality rate ( P > 0.05). Conclusion: Patients with left coronary artery dominance had a higher value of indicators of worse outcomes, such as lower LVEF and TIMI ≤ 2, compared with RD patients, but not different rates of success or complications of PCI, in-hospital, and 1-year mortality. This finding may suggest that interventionists should prepare themselves with protective measures for no-reflow and slow-flow phenomenon and also mechanical circulatory support before performing PPCI in LD patients.

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The Relation between Left Coronary Dominancy and Atherosclerotic Involvement of Left Anterior Descending Artery Origin

Cited by 3 publications

References 125 publications

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

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

Variations of The Coronary Arteries in The Population of Sohag Governorate

Association of coronary artery dominance and mortality rate and complications in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

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