Morphometric analysis of coronary artery bifurcations in normal human hearts based on X-ray examination in individuals of different sexes in the second period of mature and elderly age

Andrey V. Dmitriev; Anna A. Sergienko; Ilia S. Miltykh; Oleg K. Zenin

doi:10.12731/2658-6649-2026-18-1-1383

Andrey V. Dmitriev V.K.Gusak Institute of Emergency and Reconstructive Surgery https://orcid.org/0000-0002-0753-7586
Anna A. Sergienko Penza State University https://orcid.org/0009-0005-1380-8767
Ilia S. Miltykh University of Palermo https://orcid.org/0000-0002-9130-3255
Oleg K. Zenin Penza State University https://orcid.org/0000-0002-5447-1989

DOI: https://doi.org/10.12731/2658-6649-2026-18-1-1383

Keywords: coronary arteries of the heart, radiographs, morphometry, bifurcations, Murray C.D. law

Abstract

Background. The ratio of the inner diameters of arterial segments (AS) constituting arterial bifurcations (AB) of the human coronary arteries (HCA) is used to classify AB lesions and develop a standard protocol for surgical intervention to eliminate AS lumen narrowing. However, the question of the quantitative norm of the HCA AB structure remains open.

Purpose. To establish morphometric patterns of the ratios of the inner diameters of AS constituting AB in the norm by retrospective analysis of HCA radiographs in individuals of different sexes, the second period of mature and elderly age.

Materials and methods. A retrospective morphometric analysis of HCA radiographs (individuals of the 2nd period of mature age - 48. and elderly age - 14; males - 31 and females - 31; left coronary artery - 62 and right coronary artery 60) without visible stenotic lesions was performed. HCA was considered as a system consisting of AB, which includes a proximal AS (D) and two distal AS (d_max and d_min). The following were calculated: γ, the asymmetry coefficient of daughter branches: γ=(d_min/d_max)²; η, branching coefficient: η=(d_max²+d_min²)/D². The statistical package R (version 4.1) was used for analysis.

Results. It was found that: the values of the inner diameter D and d_max of AS constituting AB included in the HCA of males are significantly larger than those of females; the values of D, d_max and d_min of AS constituting AB included in the HCA of individuals of the 2nd period of mature age are significantly larger than those of elderly individuals; the values of D, d_max, d_min, γ and η are noticeably larger in the AS of the left coronary artery than in the right; AB included in the left coronary artery of the heart are more "symmetrical" than those constituting the right coronary artery.

Conclusion. The obtained data indicates the need for further morphometric studies of HCA, revision of Murray C.D.'s law, and development of a universal unifying theory of the structure and functioning of AB.

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Author Biographies

Andrey V. Dmitriev, V.K.Gusak Institute of Emergency and Reconstructive Surgery

Dr. Sc. (Medicine), Head of the Department of Endovascular Surgery

Anna A. Sergienko, Penza State University

Postgraduate

Ilia S. Miltykh, University of Palermo

Graduate student

Oleg K. Zenin, Penza State University

Dr. Sc. (Medicine), Professor of Human anatomy

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