El dominansı ve koroner dominans arası ilişki

Öz

Amaç: Koroner arter hastalığının bilinen risk faktörlerinin dışında, koroner dominans, ektazi, bifürkasyon açısı gibi anatomik risk faktörleride mevcuttur. Fonksiyonel bir serebral lateralizasyon olarak kabul edilen el dominansının bazı hastalıklarla ilişkisi daha önce tanımlanmıştır. Bu çalışmanın amacı genetik faktörler ile belirlenen el dominansı ve koroner dominans arası ilişkiyi tanımlamaktır.

Gereç ve Yöntemler: Polikliniğe başvuran, koroner anjiyografi uygulanmış 226 hastanın koroner anjiyografileri değerlendirildi. Hastalar sağ koroner dominant, sol dominant ve dengeli dominant olarak gruplandırıldı. Hastaların el tercihlerini belirlemek için "Oldfield Anketi" kullanıldı. Hastalar sağ el baskın, sol el baskın ve her iki elde baskınlık olarak üç gruba ayrıldı. Koroner dominans ve el dominansı arasındaki ilişki araştırıldı.

Bulgular:  Anjiyografisi yapılan 226 hastanın 96'sı (%42,5) kadın, 130' u (%57,5) erkekti. 170 hasta (%75, 2) sağ el, 14 hasta sol el (%6,2) ve 42 hasta (%18,6) her iki el baskınlığına sahipti. 160 hastada sağ koroner dominans (%70, 8), 26 hastada sol koroner dominans (%11,5) ve 40 hastada (%17,7) dengeli koroner dominans belirlenmiştir. El dominansı ile cinsiyet arasında istatiksel olarak anlamlı fark bulunamamıştır (p: 0,309). Koroner dominans ve cinsiyet arası anlamlı bir ilişki saptanmamıştır (p:0,114). Koroner arter dominansı ile serebral fonksiyonel dominans arasında istatistiksel olarak anlamlı bir ilişki vardır (p: 0,005).

Sonuç: Çalışmamızda koroner arter dominansı ve serebral fonksiyonel dominans arasında istatistiksel olarak anlamlı bir ilişki saptanmıştır. Ancak serebral ve koroner dominansı anatomik düzeyde karşılaştırmak için dominant hemisferi daha net olarak gösteren invaziv bir test olan wada testi ile yapılacak ileri çalışmalara ve anatomik lateralizasyonu karşılaştıran kadavra çalışmalarına ihtiyaç vardır.

Anahtar Kelimeler

• el dominansı,koroner dominans,serabral lateralizasyon

Relationship between hand dominance and coronary dominance

Öz

Aim: Coronary artery disease is present in anatomic risk factors such as dominance, ectasia, bifurcation angle other than standard risk factors. The association of cerebral lateralization and hand dominance with some diseases has been described previously. The aim of this study is to investigate the relationship between hand dominance and coronary dominance determined by genetic factors.
Material and Methods: Coronary angiograms of 226 patients who underwent coronary angiography were evaluated for coronary dominance. Patients were grouped as right, left and balanced dominance. The "Oldfield Survey" was used to determine patients' hand preferences. Patients were divided into three groups: left-hand, right-hand dominant and ambidextrous patients. The relationship between coronary dominance and hand dominance was investigated.
Results: Of the 226 patients who underwent angiography, 96 (42.5%) were female and 130 (57.5%) were male.170 patients (75.2%) had right hand, 14 patients had left hand (6.2%), and 42 patients (18.6%) had both hand dominance. Right coronary artery dominanace was found in 160 patients (70.8%), left coronary dominance in 26 patients (11.5%) and balanced coronary dominance in 40 patients (17.7%). There was no statistically significant difference between hand dominance and gender (p: 0.309). There was a statistically significant relationship between coronary artery dominance and cerebral functional dominance (p: 0.005).

Conclusion:In conclusion, there was a significant relationship between coronary artery and cerebral functional dominance. However, cadaver studies are needed to compare cerebral and coronary dominance with advanced studies and anatomical lateralization with the wada test, which is an invasive test that shows us more clearly the dominant hemisphere.

Anahtar Kelimeler

• hand dominance,coronary dominance,cerebral lateralization

Kaynakça

1. 1)Geschwind N, Galeburda AM. Cerebral lateralization biological mechanisms. Arch Neurological 1985; 42: 428-59.
2. 2)Ghaffari S, Kazemi B, Dadashzadeh J, Sepehri B. The relation between left coronary dominancy and atherosclerotic involvement of left anterior descending artery origin. J Cardiovasc Thorac Res 2013; 5: 1-4.
3. 3)Candır N, Ozan H, Kocabıyık N, Kusaklıgil H. Anatomical risk factors of coronary heart disease, Trakya Univ Tip Fak Derg 2010; 27: 248-52.
4. 4)Yıldırım S, Dane S. Cerebral lateralization and hand preference. The Eurasian Journal of Medicine 2007; 39: 45-48.
5. 5) Rogers LJ. Factors influencing development of lateralization. Cortex 2006; 42: 107-09.
6. 6) Subirana A. The relationship between handedness and language function. Int J Neurol 1964; 4: 215-34.
7. 7) Kütükçüoğlu Y. El Baskınlığının Yönü ve Derecesinin Araştırılması. Ankara: Gata Nöroloji Anabilim Dalı 1993, Uzmanlık Tezi
8. 8) Annett M. The distribution of manual asymmetry. Br J Psychol 1972; 63: 343- 58. (1972).

9. 9) Özdemir B, Soysal A.Ş. Yaşama farklı bir açıdan bakış: sol elim. Sted 2004;13:131-133.
10. 10) Lezak, M Neuropsychological Assessment 1995(3th edition). New York: Oxford University Press.
11. 11) Oldfield RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971; 9: 97-113.
12. 12) Gündoğan NÜ. El tercihi ve dominant göz. Türkiye Klinikleri Tıp Bilimleri Dergisi 2007; 25: 35-7.
13. 13) Sosyal AŞ, Arhan E, Aktürk A, Can H. El tercihi ve el tercihini belirleyen etkenler. Türkiye Çocuk Hastalıkları Dergisi 2007; 2: 60-8.
14. 14) Bourassa DC, McManus IC, Bryden MP. Handedness and eye-dominance: a meta-analysis of their relationship. Laterality 1996; 1: 5–34.
15. 15) Dane S, Bayirli M. Correlations between hand preference and durations of hearing for right and left ears in young healthy subjects. Percept Mot Skills 1998; 86: 667–72.
16. 16)Makarovic Z, Makarovic S, Bilic-Curcic I. Sex-dependent association between coronary vessel dominance and cardiac syndrome X: a case-control study. BMC Cardiovasc Disord 2014; 14:142.
17. 17) Erdogan AR, Dane S, Aydin MD, Ozdikici M, Diyarbakirli S. Sex and handedness differences in size of cerebral ventricles of normal subjects. Int J Neurosci 2004; 114: 67–73.
18. 18) David GN, Aristeu CN, Rodrigo RG, Orlando FRJ. Posterior arterial circle of Willis anatomic variations and coronary artery dominance: is there a correlation? Autopsy and Case Reports 2011; 3: 3-8.
19. 19) Kizilkaya E, Kantarci M, Cinar Basekim C ve ark. Asymmetry of the height of the ethmoid roof in relationship to handedness. Laterality 2006; 11: 297–303.
20. 20) Yildirim M, Dane S, Seven B. Morphological asymmetry in thyroid lobes, and sex and handedness differences in healthy young subjects. Int J Neurosci 2006;116: 1173–79.
21. 21) Goldberg C, Dowling FE. Handedness and scoliosis convexity: a reappraisal. Spine 1990; 15: 61-64.
22. 22) Price A, Eccles R. Is there any relationship between right and left hand dominance and right and left nasal airflow dominance? J Laryngol Otol 2017;131: 846-852.
23. 23) Searleman A, Hornung DE, Stein E, Brzuszkiewicz L. Nostril dominance: differences in nasal airflow and preferred handedness. Laterality 2005; 10: 111-20.
24. 24) Cagnie B, Petrovic M, Voet D, Barbaix E, Cambier D. Vertebral artery dominance and hand preference: is there a correlation? Man Ther 2006; 11: 153-56.