Left Atrial Strain Insights in Atrial Fibrillation and the Interplay with Metabolic Syndrome

Abstract

Introduction: Understanding the interplay between metabolic syndrome and left atrial (LA) function is crucial, especially in patients newly diagnosed with atrial fibrillation (AF). We evaluated the association between subclinical atrial function and metabolic syndrome in patients diagnosed with new-onset AF. Methods: A retrospective analysis was conducted on 220 patients, aged between 20 and 100 years, who were newly diagnosed with AF. These patients were divided into two groups based on the presence or absence of metabolic syndrome. LA reservoir strain, a measure of LA function, was assessed using transthoracic echocardiography. Statistical methods, including receiver operating characteristic (ROC) curve and logistic regression analyses, were employed to evaluate the association between LA strain and metabolic syndrome. Results: Among the 220 patients, 108 had metabolic syndrome and displayed more adverse clinical characteristics. The LA reservoir strain was significantly lower in this group (9.7% ± 5.2% vs. 12.0% ± 5.8%, p = 0.003). ROC curve analysis identified 9.3% as the optimal cutoff value for predicting metabolic syndrome, with a sensitivity of 50.9% and specificity of 70.5%. Further, multivariate analysis confirmed that an LA reservoir strain below 9.3% was independently linked to metabolic syndrome (odds ratio 4.261, 95% confidence interval 1.134–16.009, p = 0.032). Conclusions: The findings reveal a significant association between lower LA reservoir strain values and the presence of metabolic syndrome in patients newly diagnosed with AF. An LA strain value below 9.3% serves as a critical diagnostic and prognostic indicator, highlighting its clinical importance in managing patients with AF.