{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:16:34Z","timestamp":1783350994307,"version":"3.54.6"},"reference-count":20,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Coronary dominance is a key anatomical variant in the interpretation of coronary artery disease and its correlation with electrocardiographic (ECG) findings. While right dominance is the most common pattern, left dominance may influence clinical and ECG presentations. This study aimed to determine the prevalence of coronary dominance using coronary CT angiography (CCTA) and evaluate its association with disease severity, gender, and ECG findings. Methods: A retrospective observational analytical study was conducted including 677 patients who underwent CCTA. Coronary dominance was classified as right, left, or codominant. Disease severity was assessed using CAD-RADS. Demographic, clinical, anatomical, and ECG variables were analyzed. Statistical analysis included descriptive statistics, chi-square tests, and multivariable logistic regression analysis. Results: Right coronary dominance was predominant (89.7%), followed by left dominance (8%) and codominance (2.3%). No significant association was found between coronary dominance and disease severity or gender (p = 0.32). Male gender was significantly associated with severe disease (CAD-RADS 4\u20135) (p &lt; 0.005). The left anterior descending (LAD) artery was the most frequently affected vessel. In the left dominance subgroup, 72.2% of patients had a normal ECG, with a low prevalence of ischemic findings (3%). Cases of left dominance with severe disease and confirmed acute coronary syndrome were identified. Conclusions: Coronary dominance is not associated with disease severity or gender; however, left dominance represents a clinically relevant finding due to its association with atypical or normal ECG presentations. Its systematic inclusion in CCTA reports is recommended to improve clinical correlation and decision-making.<\/jats:p>","DOI":"10.3390\/jcm15135258","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:43:14Z","timestamp":1783345394000},"page":"5258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Coronary Dominance on Coronary CT Angiography: Prevalence and Potential Implications for Electrocardiographic Correlation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8992-4175","authenticated-orcid":false,"given":"William Andr\u00e9s","family":"Prada Mancilla","sequence":"first","affiliation":[{"name":"Department of Cardiac Imaging, Cl\u00ednica Reina Sof\u00eda, Bogota 110121, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Imaging, Cl\u00ednica Reina Sof\u00eda, Bogota 110121, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Imaging, Cl\u00ednica Reina Sof\u00eda, Bogota 110121, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Task Force Members, Steg, P.G., James, S.K., Atar, D., Badano, L.P., Lundqvist, C.B., Borger, M.A., Di Mario, C., Dickstein, K., and Ducrocq, G. (2012). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur. Heart J., 33, 2569\u20132619.","DOI":"10.1093\/eurheartj\/ehs215"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.repc.2014.10.008","article-title":"Noninvasive anatomical and functional assessment of coronary artery disease","volume":"34","author":"Ramos","year":"2015","journal-title":"Rev. Port. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"441","DOI":"10.4244\/EIJY15M09_04","article-title":"Acute myocardial infarction and lesion location in the left circumflex artery: Importance of coronary artery dominance","volume":"12","author":"Waziri","year":"2016","journal-title":"EuroIntervention"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/0002-9149(89)91069-2","article-title":"Surface electrocardiogram in the detection of transmural myocardial ischemia during coronary artery occlusion","volume":"63","author":"Berry","year":"1989","journal-title":"Am. J. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1016\/0735-1097(88)92594-6","article-title":"A comprehensive analysis of myocardial infarction due to left circumflex artery occlusion: Comparison with infarction due to right coronary artery and left anterior descending artery occlusion","volume":"12","author":"Huey","year":"1988","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1093\/ehjci\/jeu314","article-title":"Coronary dominance and prognosis in patients undergoing coronary computed tomographic angiography: Results from the CONFIRM (COronary CT Angiography EvaluatioN for Clinical Outcomes: An InteRnational Multicenter) registry","volume":"16","author":"Gebhard","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1378\/chest.120.5.1540","article-title":"Diagnosis of acute myocardial infarction in angiographically documented occluded infarct vessel: Limitations of ST-segment elevation in standard and extended ECG leads","volume":"120","author":"Schmitt","year":"2001","journal-title":"Chest"},{"key":"ref_8","first-page":"1092","article-title":"Correlation between index electrocardiographic patterns and pre-intervention angiographic findings: Insights from the HORIZONS-AMI trial","volume":"79","author":"Rokos","year":"2012","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"513","DOI":"10.6026\/97320630018513","article-title":"Coronary dominance among the Indian aborted fetal hearts","volume":"18","author":"Khokhariya","year":"2022","journal-title":"Bioinformation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s00276-023-03193-w","article-title":"Multi-slice CT analysis of the length of left main coronary artery: Its relation to sex, age, diameter and branching pattern of left main coronary artery, and coronary dominance","volume":"45","author":"Javed","year":"2023","journal-title":"Surg. Radiol. Anat."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/j.ahj.2009.08.024","article-title":"Magnitude and consequences of missing the acute infarct-related circumflex artery","volume":"158","author":"Krishnaswamy","year":"2009","journal-title":"Am. Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/BF03086001","article-title":"Circumflex artery-related acute myocardial infarction: Limited ECG abnormalities but poor outcome","volume":"15","author":"Rasoul","year":"2007","journal-title":"Neth. Heart J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.amjcard.2011.05.027","article-title":"Left circumflex occlusion in acute myocardial infarction (from the National Cardiovascular Data Registry)","volume":"108","author":"Stribling","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1540-8183.2010.00599.x","article-title":"Clinical outcomes in patients with acute left circumflex\/obtuse marginal occlusion presenting with myocardial infarction","volume":"24","author":"Stribling","year":"2011","journal-title":"J. Interv. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.tcm.2016.08.002","article-title":"Sex differences in nonobstructive coronary artery disease: Recent insights and substantial knowledge gaps","volume":"27","author":"Paul","year":"2017","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"361","DOI":"10.7326\/0003-4819-155-6-201109200-00004","article-title":"Health care system delay and heart failure in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention","volume":"155","author":"Terkelsen","year":"2011","journal-title":"Ann. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/S0735-1097(99)00249-1","article-title":"Acute myocardial infarction with isolated ST-segment elevation in posterior chest leads V7-9: \u201chidden\u201d ST-segment elevations revealing acute posterior infarction","volume":"34","author":"Matetzky","year":"1999","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/j.jacc.2008.07.029","article-title":"Anatomic distribution of the culprit lesion in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention","volume":"52","author":"Dixon","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e032851","DOI":"10.1161\/JAHA.123.032851","article-title":"Clinical Significance of Coronary Arterial Dominance: A Review of the Literature","volume":"13","author":"Wu","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Sun, B., Liu, H., Ma, L., Li, T., Shi, J., Yang, X., Ma, G., and Wu, X. (2025). Identification of NSTE-ACS patients with totally occluded infarct-related artery: The role of the SAVE risk score in improved risk stratification. Front. Cardiovasc. Med., 12.","DOI":"10.3389\/fcvm.2025.1560369"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5258\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:39:26Z","timestamp":1783348766000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":20,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15135258"],"URL":"https:\/\/doi.org\/10.3390\/jcm15135258","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}