The authors clarify that prior myocardial infarction did not confound their findings regarding physiological differences between the LAD and LCx.
In Response: We thank Drs Yan and Jiang for their thoughtful comments on our article on pressure-derived indices in the left main coronary artery (LMCA).¹ First, we agree that prior myocardial infarction and scar can impact physiological indices in the relevant territory.² However, none of the 10 patients with a history of myocardial infarction in our study had wall motion abnormalities in the LMCA territory. In those who underwent cardiac magnetic resonance imaging, late gadolinium enhancement was subendocardial and confined to the right coronary artery territory. Therefore, the principal conclusion of our study—that indices of coronary physiology are inherently different between the left anterior descending artery (LAD) and the left circumflex artery (LCx)—remains valid.
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Demir et al. (2025) studied this question.
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