title: Correspondence between left ventricular 17 myocardial segments and coronary anatomy obtained by multi-detector computed tomography: an ex vivo contribution.
abstract: OBJECTIVE
  The aim of this study was to investigate the correspondence between the coronary arterial anatomy and the supplied myocardium based on the proposed American Heart Association (AHA) 17-segment model.
  
  
  METHODS
  Six human cadaveric hearts without signs of infarct were selectively injected with colored contrasted gelatin in the three major coronary arteries. After injection, the hearts were scanned by computed tomography (64-detector scanner LightSpeed VCT, GE Healthcare) with a collimation of 64 × 0.625 mm. Reconstructed image data were analyzed in order to evaluate the blood supply of each myocardial segment.
  
  
  RESULTS
  Coronary artery territory varies due to anatomy variations. Left anterior descending coronary artery (LAD) was the main vessel responsible for the myocardium blood supply in 11 segments. LAD contributed to the blood supply of all apical segments. Left circumflex (LCx) was the main coronary artery for the infero-anterior wall. Right coronary artery (RCA) contributed in all hearts for the blood supply of infero-septal segments. There was an important overlap between LAD and RCA territories at the infero-septal region and between LAD and LCx territories at the antero-lateral region.
  
  
  CONCLUSIONS
  In our experiment, LAD territory was larger than the AHA-proposed 17-segment model. The most specific segments were located at the anterior wall and supplied exclusively by LAD. No specific segment could be exclusively attributed to RCA or to LCx. Sometimes, LCx can be the most important artery for the blood supply of the inferior wall even if the origin of the posterior descending artery is the RCA.
authors.affiliation: University Clinic of Radiology, Coimbra University Hospital-Medical School, Coimbra, Portugal. donato.pj@gmail.com
authors.forename: Paulo
authors.initials: P
authors.lastname: Donato
authors.forename: P
authors.initials: P
authors.lastname: Coelho
authors.forename: C
authors.initials: C
authors.lastname: Santos
authors.forename: A
authors.initials: A
authors.lastname: Bernardes
authors.forename: F
authors.initials: F
authors.lastname: Caseiro-Alves
mesh_terms: D002102:Cadaver; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005780:Gelatin; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D005780:Gelatin