A Novel Risk Assessment Model Using Urinary System Contrast Blush Grading to Predict Contrast-Induced Acute Kidney Injury in Low-Risk Profile Patients.

Contrast-induced acute kidney injury (CI-AKI) can occur after coronary interventions despite protective measures. We evaluated the effect of urinary system contrast blush grading for predicting post-procedure CI-AKI in 486 patients with chronic coronary artery disease. Patient characteristics and blood samples were collected. Urinary system contrast blush grade was recorded during the coronary angiography and interventions. Post-procedure third to fourth day blood samples were collected for diagnosis of CI-AKI. The median age of the patients was 61 years (53-70, interquartile range), and 194 (39.9%) participants were female. Contrast-induced acute kidney injury occurred in 78 (16%) patients. By comparing full and reduced models with the likelihood ratio test, it was observed that in the reduced model, factors such as age, diabetes mellitus, body weight-adapted contrast media (CM), hemoglobin, and urinary system blush were associated with CI-AKI presence. The probability of CI-AKI presence increased slightly from grade 0 to 1 blush, but it increased sharply grade from 1 to 2 blush. According to our results, an increase in body weight-adapted CM and urinary blush grading were the main predictors of CI-AKI. These findings suggest that when body weight-adapted CM ratio exceeds 3.5 mL/kg and urinary contrast blush reaches grade 2, the patients should be followed up more carefully for the development of CI-AKI.

Long-Term Cardiac Remodeling in Elite Athletes: Assessment by Tissue Doppler and Speckle Tracking Echocardiography.

AIMS: Currently, it remains unclear whether there are differences in the long-term physiologic and adaptive changes in an athlete's heart, varying by the type of exercise undertaken. In this study, we used standard and speckle tracking echocardiography (STE) to evaluate the long-term effects of cardiac remodeling, which persisted many years after retiring from professional sports (marathon running and wrestling). METHODS AND RESULTS: Twenty-four marathon runners, 25 wrestlers, and 24 healthy subjects were included in the study. Left ventricular (LV) strain (S) and strain rate (Sr) were evaluated by apical two- (2C), three- (3C), and four-chamber (4C) imaging. Global S and Sr were calculated by averaging the 3 apical views. The participants' mean age was comparable across the 3 groups. Weight, body mass index, LV mass, LV mass index, and relative diastolic wall thickness were higher in wrestlers than the other groups (P < 0.001). Systolic and diastolic functions, evaluated using conventional echocardiography, were comparable among the 3 groups. 2C, 3C, and 4C longitudinal strain (LS), global LS (GLS), and global Sr systolic filling (SrS) values were comparable between the marathon runners and control group; however, GLS, LS-2C, GLSrS, SrS-3C, and SrS-2C values were significantly increased in wrestlers compared with the control group. CONCLUSIONS: Myocardial changes in wrestlers and marathon runners who quit sports after an extensive period were evaluated using standard echocardiographic and STE parameters. Although they had stopped playing active sports more than 10 years earlier, both the structural and functional properties of the heart were maintained in wrestlers.