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A new indicator of contrast-induced nephropathy in patients undergoing elective coronary angiography: tissue

T Gunay1, I Zengin

  • 1Department of Cardiology, Health Sciences University, Bursa City Hospital, Bursa, Turkey. drtufangunay@gmail.com.

European Review for Medical and Pharmacological Sciences
|July 17, 2023
PubMed

Insights

A novel non-invasive index, the E/(Ea × Sa) ratio, can predict contrast-induced nephropathy (CIN) in patients undergoing elective coronary angiography (ECA). This tissue Doppler-derived measure offers a valuable risk assessment tool for CIN development.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Contrast-induced nephropathy (CIN) is a complication of coronary angiography.
  • Hemodynamic instability, reflected by left ventricular end-diastolic pressure (LVEDP), contributes to CIN.
  • Invasive LVEDP measurement is challenging and not always accessible.

Purpose of the Study:

  • To assess the relationship between the tissue Doppler-derived E/(Ea × Sa) index and CIN.
  • To determine if the E/(Ea × Sa) index can serve as a non-invasive predictor of CIN.
  • To evaluate the E/(Ea × Sa) index as a surrogate for LVEDP in predicting CIN risk.

Main Methods:

  • Retrospective study of 388 patients undergoing elective coronary angiography (ECA).
  • CIN defined as a 25% or 0.5 mg/dL increase in serum creatinine within 72 hours post-ECA.
  • Doppler echocardiography used to evaluate systolic and diastolic functions; Mehran score calculated.

Main Results:

  • CIN incidence was 9.7%.
  • A positive correlation existed between LVEDP and the E/(Ea × Sa) index (r = 0.691, p < 0.001).
  • Higher E/(Ea × Sa) index (OR = 1.03, p < 0.001) and Mehran score (OR = 1.41, p < 0.001) independently predicted CIN. A threshold of >1.71 showed 75.7% sensitivity and 84.3% specificity (AUC = 0.825).

Conclusions:

  • The non-invasively measured E/(Ea × Sa) index is a viable risk indicator for CIN in patients undergoing ECA.
  • This index provides a practical alternative for assessing CIN risk.
  • E/(Ea × Sa) index aids in identifying patients at higher risk for CIN post-angiography.
Abstract

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