Original Article
Gender differences in the lumen of the left anterior descending artery—An autopsy based histomorphometric study

https://doi.org/10.1016/j.jasi.2017.01.005Get rights and content

Highlights

  • Prevalence of coronary artery disease is comparatively higher in males than females.

  • Sexual dimorphism in luminal diameter of LAD artery was studied in cadaver hearts.

  • The luminal diameter of the LAD artery was higher in males.

  • On correction with the heart weight, females had a significantly wider coronary lumen.

Abstract

Introduction

The prevalence of coronary artery disease is comparatively higher in males than females. The present research studies the sexual dimorphism in the luminal diameter of the left anterior descending artery.

Methods

The study was conducted on 35 male and 35 female cadaver hearts. This histomorphometric study was performed by using the computer assisted microscope, to understand the gender based variation in the arterial lumen.

Results

The study observed that the luminal diameter of the left anterior descending artery was higher in males. However, on correction with the weight of the heart, females showed a significantly wider coronary artery lumen, possibly indicating a better coronary flow in female hearts.

Discussion

The study observation suggests how the females are better protected from the coronary artery disease than the males. More elaborate studies on larger sample are suggested to confirm the observations of the present study.

Introduction

Coronary artery diseases (CADs) are associated with increased morbidity and mortality.1 Among the various causes of sudden deaths, CADs are listed at the top of the list as the most common cause of sudden death.2 It is described that the prevalence of CAD is much higher in men than in the women until the 5th decade of life.3 The anterior interventricular artery is a branch of the left coronary artery and it is clinically known as the left anterior descending artery (LAD). The LAD supplies the apex of the heart and the left ventricle. The blood flow through arteries is influenced by several mechanical and hydraulic factors, which influence the blood flow in the coronary circulation.4 Though there are a few studies that reported about the normal coronary artery luminal size in different populations,5, 6, 7, 8, 9, 10 the gender differences in the coronary artery lumen have not been analyzed.

The present study was aimed to analyse the histomorphometric feature of the LAD in South Indian population. The objective was to evaluate the sexual dimorphism in the luminal diameter of the LAD based on the histomorphometry and to provide a reference data for LAD dimensions in South Indian population.

Section snippets

Materials and Methods

The present study was conducted on 70 human hearts (35 males and 35 females) obtained during the medico-legal autopsies performed in the Department of Forensic Medicine and Toxicology at a medical institution. The age of the deceased ranged between 15 and 35 years. The age distribution of the study sample is shown in Fig. 1. The samples were collected after taking a written informed consent from the kith and kin of the deceased. Seventy apparently healthy cardiac autopsy specimens with intact

Results

In the present investigation, BSA, stature and body weight were significantly higher in males. BMI however, did not show any significant differences between males and females included in the study (Table 1).

Correlation of heart weight was analysed with stature, body weight, BMI and BSA. A significant correlation of heart weight was observed with stature, body weight and BMI in males and body weight, BMI and BSA in females (Table 2). Similarly correlation of luminal diameter of LAD was drawn

Discussion

The arterial supply of the heart is interesting to the medical community. The heart receives its own blood supply from the coronary arteries. The two coronary arteries branch off from the aorta at the point where the aorta and the left ventricle meet. These arteries along with their branches supply all parts of the cardiac muscle. The coronary capillaries deliver oxygenated blood (nutrients) to all the cardiac cells.11 The coronary arteries are classified as functional end arteries, since they

Conclusions

The mean lumen diameter of the LAD was more in males as compared to the females. LAD was wider in relation to the weight of the heart in females, indicating a better coronary flow in females. There was not much difference between males and females on correction with BSA and BMI. The limitation of the present study is the smaller sample size and hence, it is recommended that similar studies are conducted on larger samples. The population considered for the present study was of South Indian

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