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Purpose  Left ventricular end-diastolic diameter (LVEDD) is a common indicator in echocardiogram, and dilated LVEDD was correlated with left ventricular insufficiency. However, it is uncertain whether dilated LVEDD is associated with increasing the risk of contrast-associated acute kidney injury (CA-AKI) in patients with coronary artery disease (CAD).    Patients and Methods  We enrolled 8,189 patients with CAD undergoing coronary angiography (CAG) between January 2007 and December 2018. Patients were divided into two groups according to the LVEDD length (normal LVEDD: men: LVEDD ≤56 mm, women: LVEDD ≤51 mm; dilated LVEDD: men: LVEDD &amp;gt;56 mm, women: LVEDD &amp;gt;51 mm). The endpoints were CA-AKI 0350  and CA-AKI 0525  (CA-AKI 0350 : an increase in the serum creatinine (Scr) level by &amp;gt;0.3 mg/dl or &amp;gt;50% within the first 48 h after CAG; CA-AKI 0525 : an absolute Scr increase ≥ 0.5 mg/dl or a relative increase ≥ 25% within 72 h after contrast medium exposure). In-hospital dialysis, 30-day mortality, and 1-year mortality were contained as well. Univariate and multivariable logistic regressions were used to assess the association between LVEDD and CA-AKI.    Results  Among 8,189 participants (men: 76.6%, mean age: 64.4 ± 10.7 years), 1,603 (19.6%) presented with dilated LVEDD. In addition, the dilated LVEDD group indicated an elevation of CA-AKI 0350  (12.4 vs. 6.2%,  p  &amp;lt; 0.001) and CA-AKI 0525  (15.0 vs. 8.8%;  p  &amp;lt; 0.001) when compared with the normal group. According to multivariable logistic analysis, dilated LVEDD was an independent predictor of CA-AKI 0350  [adjusted odds ratio (aOR): 1.31; 95% confidence interval (CI): 1.06–1.61,  p  = 0.010) and CA-AKI 0525  (aOR: 1.32; 95% CI: 1.04–1.67;  p  = 0.020).    Conclusion  In conclusion, these results demonstrated that the dilated LVEDD was a significant and independent predictor of CA-AKI following CAG in patients with CAD. Further verifications are needed to verify the association between LVEDD and CA-AKI.

Dilated Left Ventricular End-Diastolic Diameter Is a New Risk Factor of Acute Kidney Injury Following Coronary Angiography