Accelerated atherosclerosis in subjects with some minor deviations from the common type of distribution of human coronary arteries

Abstract

Gross dissection of the coronary arteries of 566 subjects aged 0–45 years from an unselected population sample of Bucharest revealed the presence of a similar anatomical branching pattern in 58% of cases. Starting from this common type of distribution of coronary arteries, some minor deviations were detected coexisting with a thicker intima, a more rapid onset and evolution of atherosclerosic plaques, and a more important degree of luminal obstruction. Among the 15 minor deviations described in this paper, 3 were constantly associated, 9 only occasionally associated and 3 not associated with an accelerated atherosclerosis. The most important of these atherogenic deviations was present in 29% of cases or in 1 out of every 3 or 4 subjects. In essence, these deviations consisted of an excessive increase in external diameter and length of the left coronary arterial system, coexisting with an underdeveloped right coronary arterial system, or vice versa. The atherogenic deviations from the common type of distribution of the coronary arteries seemed to represent an important genetically transmitted risk factor for coronary heart disease.