Hutchins G M, Nazarian I H, Bulkley B H
Am J Cardiol. 1978 Jul;42(1):57-9. doi: 10.1016/0002-9149(78)90985-2.
Clinical angiographic studies have documented an association of left dominance of the coronary arteries with aortic stenosis and congenital bicuspid aortic valve. The postmortem arteriograms of 973 autopsy patients were reviewed for pattern of coronary dominance and the hearts examined for the nature of any aortic valve disease. There were 673 hearts (70 percent) with a right dominant pattern, 198 (20 percent) with equal dominance and 102 (10 percent) with left dominance. Of 34 hearts with congenital bicuspid aortic valve, 10 (29 percent) had left dominance, a difference significant at the 0.005 level. Of 44 hearts with calcific aortic stenosis, an acquired valve lesion, 9 (20 percent) had left dominance. Rheumatic aortic valve disease (47 cases) and aortic regurgitation (27 cases) had no apparent relation to the coronary arterial pattern. The results confirm the association of left coronary arterial dominance with congenital bicuspid aortic valve. It is suggested that a left dominant coronary system may arise as a consequence of disproportionately decreased blood flow in the left heart chambers, one cause of which is aortic valve stenosis, during early cardiogenesis.
临床血管造影研究已证明冠状动脉左优势型与主动脉瓣狭窄及先天性二叶式主动脉瓣之间存在关联。回顾了973例尸检患者的死后动脉造影，以确定冠状动脉优势型模式，并检查心脏有无任何主动脉瓣疾病。有673例心脏（70%）为右优势型，198例（20%）为均衡优势型，102例（10%）为左优势型。在34例患有先天性二叶式主动脉瓣的心脏中，10例（29%）为左优势型，在0.005水平差异显著。在44例患有钙化性主动脉瓣狭窄（一种后天性瓣膜病变）的心脏中，9例（20%）为左优势型。风湿性主动脉瓣疾病（47例）和主动脉瓣关闭不全（27例）与冠状动脉模式无明显关联。结果证实了冠状动脉左优势型与先天性二叶式主动脉瓣之间的关联。有人提出，左优势型冠状动脉系统可能是由于在心脏发育早期左心腔血流不成比例减少所致，其中一个原因是主动脉瓣狭窄。
