Relationship Between Cerebral Lateralization, Coronary Artery Disease, Coronary Artery Anomalies and Coronary Arterial Dominance

Year 2021, Volume: 10 Issue: 1, 112 - 119, 30.04.2021

Mehmet Coşgun , Ertan Yetkın

https://doi.org/10.47493/abantmedj.2021.40

Abstract

INTRODUCTION: Besides the well-known classic risk factors and newly described minor risk factors of Coronary Artery Disease (CAD); novel risk factors so-called “geometric risk factors” are recently being investigated. The association of cerebral lateralization (CL) with other diseases has been defined formerly. The aim of this study was to investigate the relationship between CL and CAD, coronary artery anomaly, coronary artery dominance.
METHODS: 1069 consecutive patients who underwent coronary angiography in our Clinics between May 2009 and March 2010 were included in the study. The presence and the stage of coronary arterial stenosis, the anatomic variations and coronary artery anomalies, coronary artery dominance and the shape of RCA (S or C) were defined. Hand preferences of the patients in regard to CL were defined with “10 Items Edinburgh Questionnaire” and subjects were divided into three groups as follows: left-handed, right-handed and mixed-handed. Age, height, weight and the presence of CAD risk factors of the patients were recorded.
RESULTS: There was no statistical difference between the three groups in terms of CAD, coronary artery anomalies and coronary artery dominance. The median age was significantly lower in the left-handeds compared to the right-handeds. There was no difference between 38 left-handeds and 38 right- handeds in terms of coronary artery anomalies and coronary artery dominance.
DISCUSSION and CONCLUSION: Lower rates of coronary artery stenosis and number of involved arteries were lower in the left-handed patients, suggesting that right-handed people may be at a higher risk of CAD than the left-handed ones.

Keywords

Cerebral lateralization, Coronary Artery Disease, Coronary artery dominance, Coronary artery anomaly

Serebral Lateralizasyon, Koroner Arter Hastalığı, Koroner Arter Anomalileri ve Koroner Arter Baskınlığı Arasındaki İlişki

Abstract

INTRADUCTION: Besides the well-known classic risk factors and newly described minor risk factors of Coronary Artery Disease (CAD); novel risk factors so-called “geometric risk factors” are recently being investigated. The association of cerebral lateralization (CL) with other diseases has been defined formerly. The aim of this study was to investigate the relationship between CL and CAD, coronary artery anomaly, coronary artery dominance.
METHODS: 1069 consecutive patients who underwent coronary angiography in our Clinics between May 2009 and March 2010 were included in the study. The presence and the stage of coronary arterial stenosis, the anatomic variations and coronary artery anomalies, coronary artery dominance and the shape of RCA (S or C) were defined. Hand preferences of the patients in regard to CL were defined with “10 Items Edinburgh Questionnaire” and subjects were divided into three groups as follows: left-handed, right-handed and mixed-handed. Age, height, weight and the presence of CAD risk factors of the patients were recorded.
RESULTS: There was no statistical difference between the three groups in terms of CAD, coronary artery anomalies and coronary artery dominance. The median age was significantly lower in the left-handeds compared to the right-handeds. There was no difference between 38 left-handeds and 38 right- handeds in terms of coronary artery anomalies and coronary artery dominance.
DISCUSSION and CONCLUSION: Lower rates of coronary artery stenosis and number of involved arteries were lower in the left-handed patients, suggesting that right-handed people may be at a higher risk of CAD than the left-handed ones.

Serebral Lateralizasyon, Koroner Arter Hastalığı, Koroner Arter Anomalileri ve Koroner Arter Baskınlığı Arasındaki İlişki

ÖZ
GİRİŞ ve AMAÇ: Koroner Arter Hastalığının (KAH) iyi bilinen klasik risk faktörleri ve yeni tanımlanan minör risk faktörlerinin yanı sıra; "geometrik risk faktörleri" olarak adlandırılan yeni risk faktörleri son zamanlarda araştırılmaktadır. Serebral lateralizasyonun (SL) diğer hastalıklarla ilişkisi daha önce tanımlanmıştı. Bu çalışmanın amacı, KAH ile SL, koroner arter anomalisi, koroner arter baskınlığı arasındaki ilişkiyi araştırmaktır.
YÖNTEM ve GEREÇLER: Kliniğimizde Mayıs 2009-Mart 2010 tarihleri arasında koroner anjiyografisi yapılan ardışık 1069 hasta çalışmaya dahil edildi. Koroner arter darlığının varlığı ve evresi, anatomik varyasyonlar ve koroner arter anomalileri, koroner arter baskınlığı ve RCA (S veya C) şekli tanımlandı. Hastaların SL'ye ilişkin el tercihleri “10 Maddeli Edinburg Anketi” ile tanımlandı ve denekler şu şekilde üç gruba ayrıldı: solak, sağ elini kullanan ve her iki eklini kullanan. Hastaların yaş, boy, kilo ve KAH risk faktörlerinin varlığı kaydedildi.
BULGULAR: Üç grup arasında KAH, koroner arter anomalileri ve koroner arter baskınlığı açısından istatistiksel olarak fark yoktu. Ortanca yaş, sağ elini kullananlara kıyasla sol elini kullananlarda önemli ölçüde daha düşüktü. Koroner arter anomalileri ve koroner arter baskınlığı açısından 38 sol el ile 38 sağ el arasında fark yoktu.
TARTIŞMA ve SONUÇ: Solak hastalarda daha düşük koroner arter darlığı oranları ve tutulan arter sayısının daha düşük olması sağ elini kullananların solaklara göre daha yüksek KAH riski altında olabileceğini düşündürmektedir.

Keywords

Cerebral lateralization, Coronary Artery Disease, Coronary artery dominance, Coronary artery anomaly, Serebral lateralizasyon, Koroner Arter Hastalığı, Koroner arter baskınlığı, Koroner arter anomalisi

References

• 1. Friedman MH, Baker PB, Ding Z, Kuban BD. Relationship between the geometry and quantitative morphology of the left anterior descending coronary artery. Atherosclerosis. 1996;125(2):183–92. doi: 10.1016/0021-9150(96)05869-8.
• 2. Friedman MH, Brinkman AM, Qin JJ, Seed WA. Relation between coronary artery geometry and the distribution of early sudanophilic lesions. Atherosclerosis. 1993;98(2):193–9. doi: 10.1016/0021-9150(93)90128-h.
• 3. Fisher M, Fieman S. Geometric factors of the bifurcation in carotid atherogenesis. Stroke. 1990;21(2):267–71. doi: 10.1161/01.str.21.2.267.
• 4. Nguyen ND, Haque AK. Effect of hemodynamic factors on atherosclerosis in the abdominal aorta. Atherosclerosis. 1990;84(1):33–9. doi: 10.1016/0021-9150(90)90005-4.
• 5. Zhu H, Ding Z, Piana RN, Gehrig TR, Friedman MH. Cataloguing the geometry of the human coronary arteries: a potential tool for predicting risk of coronary artery disease. Int J Cardiol. 2009;135(1):43-52. doi: 10.1016/j.ijcard.2008.03.087. Epub 2008 Jul 1.
• 6. Yoon BW, Morillo CA, Cechetto DF, Hachinski V. Cerebral hemispheric lateralization in cardiac autonomic control. Arch Neurol. 1997;54(6):741-4. doi:10.1001/archneur.1997.00550180055012
• 7. Coren S, Halpern DF. Left-handedness: a marker for decreased survival fitness. Psychol Bull. 1991;109(1):90-106. doi: 10.1037/0033-2909.109.1.90.
• 8. Bryden PJ, Bruyn J, Fletcher P. Handedness and health: an examination of the association between different handedness classifications and health disorders. Laterality. 2005;10(5):429-40. doi: 10.1080/13576500442000193.
• 9. Elias LJ, Saucier DM, Guylee MJ. Handedness and depression in university students: a sex by handedness interaction. Brain Cogn. 2001;46(1-2):125-9.
• 10. Smith J. Left-handedness: its association with allergic disease. Neuropsychologia. 1987;25(4):665-74. doi: 10.1016/0028-3932(87)90057-1.
• 11. Ghchime R, Benjelloun H, Kiai H, Belaidi H, Lahjouji F and Ouazzani R. Cerebral Hemispheric Lateralization Associated with Hippocampal Sclerosis May Affect Interictal Cardiovascular Autonomic Functions in Temporal Lobe Epilepsy. Epilepsy Res Treat. 2016;2016:7417540. doi: 10.1155/2016/7417540. Epub 2016 Feb 24.
• 12. Von Lüdinghausen M. The clinical anatomy of coronary arteries. Adv Anat Embryol Cell Biol.. 2003;167:III-VIII, 1-111.
• 13. Celik T, Iyisoy A, Kursaklioglu H, et al. Does coronary artery size really matter? Echocardiogr-J Card. 2005;22(6):479-86
• 14. Yetkin E and Waltenberger J. Novel insights into an old controversy: is coronary artery ectasia a variant of coronary atherosclerosis? Clin Res Cardiol. 2007;96(6):331-39. doi: 10.1007/s00392-007-0521-0.
• 15. Demirbag R, and Yilmaz R. Effects of the shape of coronary arteries on the presence, extent, and severity of their disease. Heart Vessels. 2005; 20(5):224-29. doi: 10.1007/s00380-005-0837-5.
• 16. Oldfield RC. The assesment and analysis of handedness: The Edinburgh Inventory. Neuropsychologia. 1971;9(1): 97-113. doi: 10.1016/0028-3932(71)90067-4.
• 17. Tan U, Caliskan S. Allometry and asymmetry in the dog brain: right hemisphere is heavier regardless of paw preference. Inf J Neurosci. 1987;35(3-4):189-94. doi: 10.3109/00207458708987127.
• 18. Geschwind N, Galaburda AM. Cerebral lateralization. Biological mechanisms, associations, and pathology: I. A hypothesis and a program for research. Arch Neurol. 1985;42(5):428-59. doi: 10.1001/archneur.1985.04060050026008.
• 19. Milenković S, Belojević G, Kocijancić R. Aetiological factors in left-handedness. Srp Arh Celok Lek. 2005;133(11-12):532-4. doi: 10.2298/sarh0512532m.
• 20. Cole J. Paw preferences in cats related to hand preferences in animals and men. J Comp Physiol Psychol. 1955;48(2):137-40. doi: 10.1037/h0040380.
• 21. Annett M. The distribution of manual asymmetry. Br J Psychol. 1972;63(3):343-58. doi:10.1111/j.2044-8295.1972.tb01282.x.
• 22. Raymond M, Pontier D, Dufour AB, Moller AP. Frequency-dependent maintenance of left handedness in humans. Proc Biol Sci. 1996;263(1377):1627–33. doi:10.1098/rspb.1996.0238.
• 23. Foster PS, Hubbard T, Yung RC, et al. Cerebral asymmetry in the control of cardiovascular functioning: Evidence from lateral vibrotactile stimulation. Laterality. 2013;18(1):108-19. doi: 10.1080/1357650X.2011.631545. Epub 2012 Jan 30.
• 24. Lane RD, Caruso AC, Brown VL, et al. Effects of non-right-handedness on risk for sudden death associated with coronary artery disease. Am J Cardiol. 1994;74(8):743-7. doi: 10.1016/0002-9149(94)90426-x.
• 25. Roy B, Woo M, Kumar R. Cerebral blood flow in the central autonomic network: is there any effect of hemispheric lateralization in patients with heart failure? Reply. Eur J Heart Fail. 2018 ;20(4):830-1. doi: 10.1002/echo.1033. Epub 2017 Oct 18.