Objective To explore the correlation between cardiac remodeling and the occurrence of contrast-associated acute kidney injury (CA-AKI) assessed by echocardiography.

Methods A retrospective analysis was conducted on the clinical data of 100 patients with coronary artery disease (CAD) who underwent coronary angiography (CAG) and percutaneous coronary intervention (PCI) from March 2021 to March 2024.The patients were divided into CA-AKI group and non-CA-AKI group according to whether CA-AKI occurred.Baseline data and echocardiographic parameters, including left ventricular end-diastolic internal diameter index (LVIDDI), left ventricular end-systolic internal diameter index (LVIDSI), and left ventricular mass index (LVMI), were collected and compared between the two groups.Logistic regression analysis was used to screen for independent influencing factors of CA-AKI occurrence.

Results The level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the CA-AKI group was higher than that in the non-CA-AKI group, and the difference was statistically significant (P < 0.001).Compared with the non-CA-AKI group, the CA-AKI group had higher levels of C-reactive protein and glycosylated hemoglobin (HbA1c), as well as a higher proportion of patients with diabetes and anemia, and the differences were statistically significant (P < 0.05).Echocardiographic data showed that LVMI, LVIDDI, and LVIDSI in the CA-AKI group were all higher than those in the non-CA-AKI group, and the differences were statistically significant (t=2.057, 3.429, 2.975;P < 0.05).The left ventricular ejection fraction (LVEF) level in the CA-AKI group was lower than that in the non-CA-AKI group, and the difference was statistically significant (t=3.005, P=0.003).Univariate Logistic regression analysis showed that diabetes, anemia, inflammation, NT-proBNP, HbA1c, LVMI, LVIDDI, LVIDSI, LVEF, ventricular hypertrophy, and ventricular dilation were significantly associated with the occurrence of CA-AKI (P < 0.05).Multivariate Logistic regression analysis results showed that LVMI (OR=3.81;95% CI, 1.04 to 8.50;P=0.045), LVIDDI (OR=4.21;95% CI, 2.02 to 6.08;P < 0.001), LVIDSI (OR=1.61;95% CI, 1.27 to 2.03;P=0.024), ventricular hypertrophy (OR=3.42;95% CI, 1.83 to 4.44;P=0.001), and ventricular dilation (OR=2.93;95% CI, 1.43 to 3.74;P=0.033) were independent influencing factors for the occurrence of CA-AKI.

Conclusion Cardiac remodeling is significantly correlated with the risk of CA-AKI in CAD patients.Clinicians should take protective measures timely for patients with abnormal cardiac structure to prevent the occurrence of CA-AKI.