Abstract Background and Aims To study the structural and functional features of the left heart in patients with coronary artery disease depending on the development of contrast-induced nephropathy (CIN) against the background of radiopaque endovascular procedures (REP). Method The study included 303 patients with stable forms of coronary artery disease who underwent X-ray endovascular procedures (REP). Patients with eGFR, determined by serum creatinine concentration, less than 60 ml/minute were not included in the study. 20 healthy volunteers were examined as a control group. All patients were divided into 2 groups - patients with an uncomplicated postoperative period of REP (CIN- group, 206 patients, 67.99%) and patients who developed contrast-induced nephropathy (CIN+ group, 97 patients, 32.01%). Subsequently, the CIN+ and CIN- groups were retrospectively compared based on baseline echocardiographic parameters. Results The present study demonstrated that EchoCG predictors of CIN in patients with stable forms of coronary artery disease are dilatation of the left ventricular (LV) cavity more than 136 ml (relative risk 1.65, p < 0.01), an increase in the index of impaired regional contractility of the LV to 1.2 points or higher (relative risk 1.77, p < 0.01) and a decrease in the e/a ratio of tissue Dopplerogram of the lateral edge of the mitral annulus to 0.7 relative units or less (relative risk 1.59, p < 0.01). Conclusion In patients with coronary artery disease after REP, despite the improvement in the index of impaired regional contractility and the index of LV sphericity, in the CIN+ group there is a more significant deterioration in the structural and functional properties of the LV myocardium, which manifested itself in an increase in systolic myocardial stress, a decrease in ejection fraction and an increase in the degree of diastolic dysfunction, which indicates a toxic effect of the radiocontrast drug not only on the kidneys, but also on the myocardium.