Correlation Between Coronary Arterial Dominance and the Degree of Coronary Artery Disease Using Computed Tomography Angiography

Haytham Al Ewaidat,1 Ammar A Oglat,2 Ali Al Makhadmeh,1 Tariq Aljarrah,3 Mohamed Abdalla Eltahir,3 Khalaf Abdel Azez Al-Masaid,1 Ahmad W E’layan,1 Moath Qasim Alawaqla,3 Ihsan I Hamarneh,4 Maisoon Mohammed Allouh,4 Ali Al-Smair4 1Department of Allied Medical Sciences-Radiologic Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Medical Imaging, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan; 3Department of Medical Radiologic Technologies, Faculty of Allied Medical Sciences, Zarqa University, Zarqa, Jordan; 4Radiology, Medray, International Medical X-ray Centers, Amman, JordanCorrespondence: Haytham Al Ewaidat, Email [email protected]: This study used Computed Tomography Angiography to evaluate how coronary artery dominance affects CAD severity.Methods: We retrospectively examined 1,000 coronary CTA patients at five private outpatient radiography clinics in Amman, Jordan. Patients of both sexes aged 18 or older with no coronary CTA contraindications were enrolled. Two 10-year-experienced radiologists reviewed all coronary CT images with 64 slices or more without knowing the patients’ medical histories.Results: The coronary arteries were right, left, or co-dominant. CAD: stenosis. Visual assessment of the lumen diameter rated coronary stenosis as 0%, mild (1– 49%), moderate (50– 69%), or severe (≥ 70%). Positive obstructive CAD can be identified when a coronary lesion compromises the lumen by ≥ 50%. A CAD patient had one, two, three, or four vascular disease. Study outcomes were assessed using descriptive statistics, t-tests, and one-way ANOVA. Right, left, and co-dominant coronary arteries predominated 85.7%, 11.6%, and 2.7%. Co-dominance caused greater right coronary artery (RCA) issues than left- or right-dominance. 22.2% of co-dominance patients reported positive RCA difficulties, compared to 6.9% and 21.0% of left- and right-dominance patients (p = 0.001). In addition, 14.8% of co-dominance patients had obstructive RCA lesions, compared to 1.7% of left-dominance and 5.3% of right-dominance (p = 0.018). The coronary dominance patterns did not affect LMCA, LAD, LCX, and Ramus blockages (p = 0.846, 0.447, 0.116, and 0.867). Calcium scores averaged 44.4 for right dominance, 41.0 for left, and 86.2 for co-dominance (p = 0.136).Conclusion: Coronary CTA may not provide more risk information than assessing stenosis in patients with normal arteries or non-significant CAD. However, it may aid RCA and obstructive CAD patients.Keywords: coronary arterial dominance, coronary artery disease, computed tomography angiograph, radiographers, Jordan