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Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
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Diastolic dysfunction and contrast-induced nephropathy in patients undergoing coronary angiography

S Acikel1, R Akdemir, H Kilic

  • 1Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, 06110, Ankara, Turkey, sadik.acikel@tkd.org.tr.

Herz
|November 30, 2014
PubMed

Insights

Left ventricular diastolic dysfunction, not just reduced ejection fraction, is linked to worsening kidney function after coronary angiography. This finding highlights diastolic dysfunction as a risk factor for contrast-induced nephropathy (CIN).

Area of Science:

  • Cardiology
  • Nephrology
  • Diagnostic Imaging

Background:

  • Decreased left ventricular ejection fraction (LVEF) is a known risk factor for contrast-induced nephropathy (CIN).
  • The role of left ventricular (LV) diastolic dysfunction in renal function decline post-coronary angiography (CAG) remains less understood.
  • Understanding these relationships is crucial for identifying patients at higher risk of CIN.

Purpose of the Study:

  • To investigate the association between LV diastolic dysfunction and renal function impairment following CAG.
  • To determine if diastolic dysfunction independently predicts contrast-induced nephropathy in patients undergoing CAG.

Main Methods:

  • Two groups of patients were compared: those with normal diastolic function (Group I) and those with abnormal diastolic function (Group II).
  • Serum creatinine (Crea) and glomerular filtration rate (GFR) were measured before and 48 hours after CAG.
  • GFR was calculated using Cockcroft-Gault and MDRD equations.

Main Results:

  • Patients with abnormal diastolic function (Group II) exhibited higher post-CAG serum creatinine levels and lower GFR compared to Group I.
  • Changes in Crea and GFR (ΔCrea, ΔGFR) were significantly greater in Group II.
  • Independent predictors of worsening renal function included older age, elevated E/E' lateral ratio, and increased left atrial volume index.

Conclusions:

  • LV diastolic dysfunction is associated with a decline in renal function after CAG, even in patients with normal LVEF.
  • Diastolic dysfunction may be a significant risk factor for developing contrast-induced nephropathy.
  • These findings suggest that diastolic function assessment could aid in stratifying CIN risk.
Abstract

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