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Inferior vena cava assessment can predict contrast-induced nephropathy in patients undergoing cardiac

Fatih Gungoren1, Feyzullah Besli1, Zulkif Tanriverdi1

  • 1Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

Echocardiography (Mount Kisco, N.Y.)
|October 11, 2018
PubMed

Insights

The caval index, measured via echocardiography, can predict contrast-induced nephropathy (CIN) after cardiac catheterization. A caval index of 41% or higher indicates a higher risk of developing CIN.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication of cardiac catheterization.
  • Patient volume status is crucial in CIN development and can be assessed noninvasively.
  • Inferior vena cava (IVC) diameter measurements offer a potential method for volume status assessment.

Purpose of the Study:

  • To evaluate the inferior vena cava (IVC) diameter as a predictor of CIN in patients undergoing cardiac catheterization.
  • To determine if the caval index can identify patients at risk for CIN.
  • To assess the independent predictive value of the caval index for CIN.

Main Methods:

  • Prospective enrollment of 269 patients undergoing cardiac catheterization.
  • Measurement of IVC inspiratory and expiratory diameters using transthoracic echocardiography.
  • Calculation of the caval index (percentage decrease in IVC diameter during respiration) and definition of CIN (serum creatinine increase).

Main Results:

  • CIN developed in 17.1% of patients.
  • Patients with CIN had a significantly higher caval index (47% vs. 35%, P < 0.001).
  • A caval index ≥ 41% independently predicted CIN development (OR: 3.367, P = 0.002).

Conclusions:

  • The caval index is a simple, noninvasive echocardiographic marker.
  • It serves as an independent predictor of post-procedural CIN.
  • This marker can aid in identifying patients at risk for CIN following cardiac procedures.
Abstract

Keywords:
cardiac catheterizationcaval indexcontrast-induced nephropathy

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