Impact of Sodium–Glucose Cotransporter-2 Inhibitors on Patient Outcomes and Left Atrial Mechanics in Atrial Fibrillation Patients: Insights from Speckle Tracking Echocardiography

Background and Aim: Evidence on the direct impact of sodium–glucose cotransporter-2 (SGLT2) inhibitors on outcomes and complications in atrial fibrillation (AF) patients, independent of diabetes status, is still limited. Therefore, this study sought to evaluate the effects of SGLT2 inhibitors in patients with AF, particularly regarding left atrial (LA) function. Materials and Methods: This prospective, multicenter observational study included 200 patients with nonvalvular persistent AF. The study population was split into two groups, with Group 1 consisting of 100 patients treated with SGLT2 inhibitors as part of their treatment regimen, whereas Group 2 comprised 100 patients who were not treated with these drugs. All participants underwent a comprehensive assessment, including detailed medical history, thorough general and local physical examination, laboratory investigations, electrocardiography, and echocardiography. Results: The present study demonstrated a marked enhancement of all parameters of LA function, including LA dimensions, volumes, emptying fraction, and strain, in the group treated with SGLT2 inhibitors. These positive effects appear to be consistent regardless of gender, comorbid conditions, or various clinical variables. Moreover, factors such as heart rate, blood pressure, hemoglobin, and platelet counts showed no significant impact on outcomes, supporting the idea that SGLT2 inhibitors directly contribute to enhanced cardiac function in AF patients. Conclusion: SGLT2 inhibitors demonstrate efficacy in improving LA function among patients with AF, emphasizing their role as a potential treatment option for AF patients with impaired LA performance.