patients had a lower peak serum creatinine after re- ceiving fenoldopam than nondiabetic patients. The role of ACE inhibitors as potential risk for RCN has been controversial. 18 In our study, patients receiving ACE inhibitor therapy (56%) had a signifi- cant increase in serum creatinine after the procedure compared with patients without ACE inhibitors (p = 0.049). However, on multivariate analysis, prior ACE inhibitor therapy showed only a trend (p = 0.08) toward RCN development. Previously established im- portant predictors such as hypertension and peripheral vascular disease were not predictors on univariate analysis. In the multivariate model, only advanced age was a significant independent predictor of RCN. Pre- viously established risk factors such as chronic renal insufficiency, diabetes mellitus, and contrast volume did not predict RCN. This finding is different from previous studies in that fenoldopam appears to be more beneficial in patients with chronic renal insuffi- ciency with or without diabetes, and this therefore changes the known predictors. In conclusion, this study demonstrates that fenoldopam is especially renoprotective in patients with baseline serum creatinine >2.0 mg/dl, with or without diabetes, undergoing PCI along with hy- dration, by reducing the incidence of RCN to <4%. Also, previously established predictive risk factors of RCN are no longer significant after ther- apy with fenoldopam. 1. McCullough P, Wolyn R, Rocher L, Levin R, O’Neill W. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997;103:368 –375. 2. Gruberg L, Mintz G, Mehran R, Dangas G, Lansky A, Kent K, Pichard A, Satler L, Leon M. The prognostic implications of further renal function deterio- ration within 48 h of interventional coronary procedures in patients with pre- existent chronic renal insufficiency. J Am Coll Cardiol 2000;36:1542–1548. 3. Rudnick M, Goldfarb S, Wexler L, Ludbrook P, Murphy M, Halpern E, Hill J, Winniford M, Cohen M, VanFossen D, for the Iohexol Cooperative Study. Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a random- ized trial. Kidney Int 1995;47:254 –261. 4. Solomon R, Werner C, Mann D, D’Elia J, Silva P. Effects of saline, mannitol, and furosemide on acute decreases in renal function induced by radiocontrast agents. N Engl J Med 1994;331:1416 –1420. 5. Deray G, Jacobs C. Radiocontrast nephrotoxicity: a review. Invest Radiol 1995;30:221–225. 6. Weisberg L, Kurnik P, Kurnik B. Risk of radiocontrast nephropathy in patients with and without diabetes mellitus. Kidney Int 1994;45:259 –265. 7. Stevens M, McCullough P, Tobin K, Speck J, Westveer D, Guido-Allen D, Timmis G, O’Neill W. A prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy: results of the PRINCE study. J Am Coll Cardiol 1999;33:403–411. 8. Taliercio C, Vlietstra R, Ilstrup D, Burnett J, Menke K, Stensrud S, Holmes D. A randomized comparison of the nephrotoxicity of Iopamidol and Diatrizoate in high risk patients undergoing cardiac angiography. J Am Coll Cardiol 1991;17: 384 –390. 9. Gare M, Haviv Y, Ben-Yehuda A, Rubinger D, Bdolah-Abram T, Fuchs S, Gat O, Popovtzer M, Gotsman M, Mosseri M. The renal effect of low-dose dopamine in high-risk patients undergoing coronary angiography. J Am Coll Cardiol 1999; 34:1682–1688. 10. Abizaid A, Clark C, Mintz G, Dosa S, Popma J, Pichard A, Satler L, Harvey M, Kent K, Leon M. Effects of dopamine and aminophylline on contrast-induced acute renal failure after coronary angioplasty in patients with preexisting renal insufficiency. Am J Cardiol 1999;83:260 –262. 11. Tepel M, van der Giet M, Schwarzfeld C, Laufer U, Liermann D, Zidek W. Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. N Engl J Med 2000;343:180 –184. 12. Bakris G, Lass N, Glock D. Renal hemodynamics in radiocontrast medium- induced renal dysfunction: a role for dopamine-1 receptors. Kidney Int 1999;56: 206 –210. 13. Kini A, Mitre C, Kim M, Kamran M, Reich D, Sharma S. A protocol for prevention of radiographic contrast nephropathy during percutaneous coronary intervention: effect of selective dopamine receptor agonist fenoldopam. Catheter Cardiovasc Interventions 2002;55:169 –173. 14. Singer I, Epstein M. Potential of dopamine A-1 agonists in the management of acute renal failure. Am J Kidney Dis 1998;31:743–755. 15. Madyoon H, Croushore L, Weaver D, Mathur V. Use of fenoldopam to prevent radiocontrast nephropathy in high-risk patients. Catheter Cardiovasc Interventions 2001;53:341–345. 16. Tumlin J, Mathur V. Efficacy of fenoldopam in preventing radiocontrast nephropathy (RCN): a randomized, double-blind, placebo-controlled trial (abstr). Catheter Cardiovasc Interventions 2000;50:128. 17. Mathur V, Swan S, Lambrecht L, Anjum S, Fellmann J, McGuire D, Epstein M, Luther R. The effects of fenoldopam, a selective dopamine receptor agonist, on systemic and renal hemodynamics in normotensive subjects. Crit Care Med 1999;27:1832–1837. 18. Louis B, Hoch B, Hernandez C, Namboodiri N, Neiderman G, Nissenbaum A, Foti FP, Magno A, Banayat G, Fata F, Namohar NL, Lipner HI. Protection from the nephrotoxicity of contrast dye. Renal Fail 1996;18:639 –646. Aortic Distensibility Is Increasing in Elite Athletes Mustafa Kemal Erol, MD, Mustafa Yilmaz, MD, Yunus Oztasyonar, Serdar Sevimli, MD, and Huseyin Senocak, MD P hysiolologic adaptations in an athlete’s heart in- clude increased left and right ventricular chamber size, increased left ventricular wall thickness and mass, and a decreased heart rate at rest. 1–3 It is known that static or isometric exercise is associated with concentric left ventricular hypertrophy, whereas en- durance training or isotonic exercise is associated with eccentric left ventricular hypertrophy. 4 Because aortic elastic properties are important determinants of blood pressure and left ventricular function, this study was performed to assess the elastic properties of aorta in elite athletes. ••• Thirty-three top-level male athletes (22  4 years), all of whom were members of professional sports teams (14 runners, 10 wrestlers, 4 boxers, and 5 bas- ketball players), and 14 age-matched healthy male controls (23  1 years) were included in the study. The athletes had been competing for a mean of 7  4 years; their mean training time was 12  4 hours/ week. Athletes who were off-training or experiencing a prolonged rest (10 days) were excluded. All sub- From the Department of Cardiology, Medical School Hospital, and Department of Physical Education and Sport, Ataturk University, Er- zurum, Turkey. Dr. Erol’s address is: Ataturk University, Medical School Hospital, Department of Cardiology, 25050 Erzurum, Turkey. E-mail: mkerol@superonline.com.tr. Manuscript received August 29, 2001; revised manuscript received and accepted January 4, 2002. 1002 ©2002 by Excerpta Medica, Inc. All rights reserved. 0002-9149/02/$–see front matter The American Journal of Cardiology Vol. 89 April 15, 2002 PII S0002-9149(02)02260-9