Diferentes critérios modificam o padrão de dominância coronariana em uma população: um estudo cadavérico

Abstract

The blood supply to the heart is carried out heterogeneously by the right and left coronary arteries. The anatomical distribution of these arteries and their branches in front of the crux cordis determines what was called coronary dominance by Schlessinger (1940), who classified hearts as right, left or balanced dominance depending on the position of the coronary arteries and their branches in relation to the crux cordis, on the diaphragmatic surface of the heart. In order to make the concept more physiologically reliable, Falci Jr. and collaborators (1994) proposed a change in this concept. There are considerable anatomical and clinical correlations for each dominance pattern, with left dominance being the one with the greatest range of associated heart diseases. The present study aimed to verify coronary dominance in human hearts from the population of Rio Grande do Norte. For this purpose, 170 hearts from adult cadavers fixed in 10% formalin from the Human Anatomy Laboratory of the Federal University of Rio Grande do Norte were dissected and analyzed using the criteria of the aforementioned authors. According to the Schlessinger criterion (1940), our study shows 73.5% of hearts with right dominance, 19.5% with balanced dominance and 7% with left dominance. According to Falci Jr et al. (1994), our data demonstrate 50.6% of right dominance, 36.5% with balanced dominance and 12.9% with left dominance. For both criteria, right dominance is predominant, followed by balanced dominance and finally left dominance. Therefore, regardless of the criterion, it is concluded that the regional population tends to present a lower risk of heart disease, although there is a need to establish a universal criterion in order to make the results more reliable.