Atherosclerotic Involvement in Patients with Left or Right Dominant Coronary Circulation

Abstract

Background. There are variations in the anatomy of the coronary arteries in patients with left dominant circulation. The influence of anatomical variations in patients with left dominant circulation on coronary arteriosclerosis is not clear. Aim. We investigated whether atherosclerotic involvement in patients with left dominant circulation differs from that in patients with right dominant circulation. Methods. We retrospectively compared 38 consecutive angiograms with left coronary dominance with 459 consecutive angiograms with right coronary dominance. By using the 29-segment coding system of the American College of Cardiology/American Heart Association, numerical values were given to each segment, according to the percentage of the decrease in luminary diameter. Using, the sum of numerical values in each coronary artery, LAD score, LCx score, RCA score, and left main coronary artery (LMCA) score were obtained. Using the sum of these 4 vessel scores, the coronary artery disease (CAD) score was calculated. Results. Total LAD score (49±48 vs 47±57), total LCx score (29±45 vs 41±58), total RCA score (32±68 vs 30±51), total LMCA score (1.8±11.3 vs 2.9±13.6) and total CAD score (108±108 vs 108±123) were similar in patients with left and right dominant circulation (all differences NS). Conclusions. The extent of coronary atherosclerosis does not depend on the type of dominant coronary circulation.