Related Experiment Video
Updated: Oct 5, 2025
Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders
Published on: February 3, 2021
A study of coronary dominance and its clinical significance
D P Aricatt1, A Prabhu2, R Avadhani3
1Department of Anatomy, Yenepoya Medical College, Yenepoya University Deralakatte, Mangalore, Karnataka, India. drdiviamanoj@gmail.com.
Insights
This study found that right cardiac dominance is most common (85.5%) in Indian patients. Left-dominant patterns showed a higher prevalence of coronary artery stenosis, impacting interventional cardiology strategies.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- Coronary artery disease (CAD) is a leading cause of death globally, particularly in developing nations.
- Understanding variations in coronary anatomy, such as cardiac dominance, is crucial for diagnosing and managing CAD.
- This study investigates the prevalence of different cardiac dominance patterns and their relationship with coronary artery stenosis.
Purpose of the Study:
- To determine the prevalence of right, left, and co-dominant coronary artery patterns in an Indian population.
- To assess the association between cardiac dominance patterns and the presence and severity of coronary artery stenosis.
- To explore potential gender differences in the distribution of cardiac dominance patterns.
Main Methods:
- Prospective analysis of 4,000 coronary angiograms from South Indian patients.
- Exclusion criteria included prior coronary artery bypass grafting, percutaneous coronary intervention, and diabetes duration of ≥5 years.
- Data collection focused on coronary vessel morphology and the prevalence of stenosis across different dominance patterns.
Main Results:
- Right cardiac dominance was observed in 85.5% of cases, left dominance in 9.7%, and co-dominance in 4.8%.
- Left dominance showed a higher prevalence of coronary artery stenosis compared to right and co-dominant patterns.
- Significant associations were found between the diameters of the right coronary artery and left circumflex coronary artery and dominance patterns.
Conclusions:
- Cardiac dominance patterns are significantly associated with coronary artery disease, aiding interventional cardiologists.
- Left-dominant and co-dominant hearts exhibited distinct coronary artery disease patterns, highlighting anatomical influences.
- Findings underscore the importance of considering cardiac dominance in the assessment and treatment of coronary artery disease.
Background:
Coronary artery disease is the most common cause of morbidity and mortality especially in the developing countries. The aim of the study was to find out cardiac dominance percentages and its association with coronary artery stenosis among each pattern of dominance. The objectives were to assess coronary vessel morphology of patients within each pattern of dominance, to find if gender differences exist among dominance patterns and also to find the distribution percentages of stenosis among dominance patterns.
Materials And Methods:
Four thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the pre-selected hospitals from four states of South India. Informed consents were obtained. Post coronary artery bypass grafting, post percutaneous coronary intervention patients and patient being diabetic for ≥ 5 years were excluded from the study.
Results:
Right cardiac dominance was seen in 85.5%, left in 9.7%, and co-dominant in 4.8% cases. The percentages of dominance were almost similar among both genders except for left dominance which were higher among male samples. The diameter of right coronary artery and left circumflex coronary artery coronary arteries were significantly associated with dominance patterns. The prevalence of stenosis was more for left dominance patterns, followed by right dominance patterns and least for co-dominant patterns.
Conclusions:
There is a necessity to see association between dominance patterns with the coronary artery disease which can help the interventional cardiologists. The disease patterns in the present study were predominantly in the left dominant or in the co-dominant hearts.
Related Concept Videos
01:26Coronary Artery Disease II: Pathophysiology
01:30Coronary Artery Disease III: Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Coronary Artery Disease I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...