Coronary artery dominance influences the amount and anatomic location of myocardium
that is perfused by the left or right coronary circulation. However, it is unknown
whether coronary artery dominance also influences the distribution of coronary blood
flow volume. The aim of this study was to evaluate volumetric coronary blood flow
in 1,322 vessels from 496 patients in the Prediction of Progression of Coronary Artery
Disease and Clinical Outcomes Using Vascular Profiling of Endothelial Shear Stress
and Arterial Wall Morphology (PREDICTION) study. Patients were divided into 2 groups
(right-dominant and left-dominant or balanced circulation). Coronary blood flow volume
was calculated by coronary segment volume measurement using angiography and intravascular
ultrasound and the contrast transit time through the segment. Coronary blood flow
in the left circumflex coronary artery was significantly higher in left-dominant or
balanced circulation than in right-dominant circulation (113 ± 43 vs 72 ± 37 ml/min,
p <0.001), whereas flow in the right coronary artery was significantly lower in left-dominant
or balanced circulation than in right-dominant circulation (56 ± 40 vs 113 ± 49 ml/min,
p = 0.003). There was no significant difference in the left anterior descending coronary
artery. In conclusion, coronary artery dominance has an impact on coronary blood flow
volume in the left circumflex and right coronary arteries but not in the left anterior
descending coronary artery. These findings suggest that the extent of myocardial perfusion
area is associated with coronary blood flow volume.
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References
- Techniques to measure coronary blood flow in man.Am J Cardiol. 1972; 29: 75-80
- Validation of volumetric flow measurements by means of a Doppler-tipped coronary angioplasty guide wire.Am Heart J. 1993; 126: 1456-1461
- Novel Doppler assessment of intracoronary volumetric flow reserve: validation against PET in patients with or without flow-dependent vasodilation.J Nucl Med. 2005; 46: 1272-1277
- Direct volumetric blood flow measurement in coronary arteries by thermodilution.J Am Coll Cardiol. 2007; 50: 2294-2304
- Quantitative study on the size of coronary artery supplying areas postmortem.Am Heart J. 1977; 94: 183-188
- Effect of endothelial shear stress on the progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans: in vivo 6-month follow-up study.Circulation. 2003; 108: 438-444
- Reproducibility of coronary lumen, plaque, and vessel wall reconstruction and of endothelial shear stress measurements in vivo in humans.Catheter Cardiovasc Interv. 2003; 60: 67-78
- Augmented expression and activity of extracellular matrix-degrading enzymes in regions of low endothelial shear stress colocalize with coronary atheromata with thin fibrous caps in pigs.Circulation. 2011; 123: 621-630
- Prediction of progression of coronary artery disease and clinical outcomes using vascular profiling of endothelial shear stress and arterial plaque characteristics: the PREDICTION study.Circulation. 2012; 126: 172-181
- Relation of anatomic pattern to pathologic conditions of the coronary arteries.Arch Pathol. 1940; 30: 403-415
- Reversal of dominance of the coronary arterial system in isolated aortic stenosis and bicuspid aortic valve.Circulation. 1975; 52: 292-296
- Relation between myocardial blood flow and the severity of coronary-artery stenosis.N Engl J Med. 1994; 330: 1782-1788
- Methods of measurement of myocardial blood flow in patients: a critical review.Circulation. 1987; 76: 245-253
- Measurement of volumetric coronary blood flow with a Doppler catheter: validation in an animal model.Am Heart J. 1992; 124: 870-875
- Quantification of volumetric coronary blood flow with dual-energy digital subtraction angiography.Circulation. 1996; 93: 1919-1927
- True 3-dimensional reconstruction of coronary arteries in patients by fusion of angiography and IVUS (ANGUS) and its quantitative validation.Circulation. 2000; 102: 511-516
- TIMI frame count: a quantitative method of assessing coronary artery flow.Circulation. 1996; 93: 879-888
- Altered coronary flow properties in diffuse coronary artery ectasia.Am Heart J. 2003; 145: 66-72
- Determinants of coronary blood flow in humans: quantification by intracoronary Doppler and ultrasound.J Appl Physiol. 2005; 98: 1076-1082
- Coronary artery flow velocity is related to lumen area and regional left ventricular mass.Circulation. 2000; 102: 48-54
- Assessing coronary blood flow dynamics with the TIMI frame count method: comparison with simultaneous intracoronary Doppler and ultrasound.Catheter Cardiovasc Interv. 2001; 53: 459-463
- Prevalence of anatomical variants and coronary anomalies in 543 consecutive patients studied with 64-slice CT coronary angiography.Eur Radiol. 2008; 18: 781-791
- Effect of potential confounding factors on the Thrombolysis In Myocardial Infarction (TIMI) trial frame count and its reproducibility.Circulation. 1999; 100: 2219-2223
Article info
Publication history
Published online: March 29, 2013
Accepted:
January 17,
2013
Received in revised form:
January 17,
2013
Received:
October 25,
2012
Footnotes
See page 1423 for disclosure information.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
