Vasheghani-Farahani Ali, Kassaian Seyed Ebrahim, Yaminisharif Ahmad, Davoodi Gholamreza, Salarifar Mojtaba, Amirzadegan Alireza, Darabian Sirous, Fotouhi Akbar, Sadigh Gelareh, Razavi Seyed Amirhossein, Hakki Elham
Department of Cardiology, Tehran Heart Center, Tehran, Iran.
Clin Anat. 2008 Sep;21(6):519-23. doi: 10.1002/ca.20669.
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.
先前已对冠状动脉优势类型与冠状动脉直径、长度及瓣膜性心脏病之间的关联进行了研究。然而，其与冠状动脉疾病（CAD）的关联尚不清楚。我们进行了调查，以确定CAD的范围和定位在右、左或共优势冠状动脉类型中是否存在差异。对德黑兰心脏中心收治的12558例接受冠状动脉造影的患者进行了回顾性研究（2004 - 2006年）。确定了CAD的范围和定位以及优势动脉。男性占62.7%。平均年龄为57.6±10.3岁。患者中分别有84.2%[95%置信区间（CI）；83.6 - 84.8%]、10.9%（95%CI；10.4 - 11.4%）和4.8%（95%CI；4.4 - 5.2%）为右优势、左优势和共优势；在各亚组中，考虑年龄、性别、阳性家族史、高血压、高脂血症、心电图、运动平板负荷试验和灌注扫描时，未见显著差异。右优势患者更倾向于患有三支血管病变（33.1%对27%，P<0.0001），右冠状动脉狭窄超过50%的比例（65.9%对57.9%，P<0.0001）以及左旋支区域（64%对59.4%，P = 0.01）高于左优势患者。左主干冠状动脉、左前降支区域和后降支的受累情况无显著差异。本研究表明血管造影显示的CAD严重程度与受累动脉区域及优势类型之间存在关联。
