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The association of heart valve diseases with coronary artery dominance

Gwilym M Morris1, Anthony L Innasimuthu, Jonathan P Fox

  • 1Division of Cardiovascular and Endocrine Sciences, University of Manchester, Liverpool, United Kingdom. gwilym.morris@postgrad.man.ac.uk

The Journal of Heart Valve Disease
|June 30, 2010
PubMed

Insights

Aortic stenosis (AS) is linked to left dominant coronary circulation, with increased prevalence alongside AS severity. However, mitral regurgitation (MR) showed a reduced prevalence of left dominance.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Aortic stenosis (AS) is primarily attributed to calcific degeneration of the aortic valve.
  • Clinical observations suggest a correlation between left dominant coronary circulation and AS.
  • Mitral regurgitation (MR) and aortic regurgitation (AR) lack established links to coronary artery dominance.

Purpose of the Study:

  • To investigate the association between coronary artery dominance and aortic stenosis (AS).
  • To explore the relationship between coronary artery dominance and other valvular heart diseases like MR and AR.

Main Methods:

  • Retrospective review of coronary angiogram database from a tertiary referral center.
  • Inclusion of consecutive left heart catheter data over a six-year period.
  • Classification of AS severity by pressure gradient; visual assessment of MR and AR.

Main Results:

  • A significant association was found between AS and left dominant coronary circulation (p < 0.0001).
  • The prevalence of left dominance increased proportionally with AS severity (p < 0.005).
  • MR was associated with a decreased prevalence of left dominance (p < 0.005), while AR showed no significant association.

Conclusions:

  • Aortic stenosis is associated with left dominant coronary circulation, with incidence rising with AS severity.
  • Mitral regurgitation exhibits an inverse relationship with left dominant coronary circulation.
  • The underlying mechanisms for these observed associations require further investigation.
Abstract

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