Impact of Subclinical Atrial Function on the Prognosis of Patients With Atrial Fibrillation and Metabolic Syndrome

Background and Objectives:The association between left atrial (LA) reservoir strain and clinical outcomes in patients with persistent atrial fibrillation (AF) and metabolic syndrome remains unclear.This study aimed to evaluate the predictive capability of LA reservoir strain for 1-year clinical composite outcomes in these patients.Methods: A retrospective analysis was conducted on 96 patients, aged 20-100 years, diagnosed with persistent AF between December 2020 and November 2021.All patients underwent transthoracic echocardiography.The primary outcome was the emergence of a composite clinical outcome, including stroke, hospitalization due to heart failure, or all-cause death, over a one-year follow-up.Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value for LA reservoir strain in predicting these outcomes.Results: During the 1-year follow-up period, 12.5% of patients experienced composite clinical outcomes.ROC curve analysis identified 8.25% as the optimal cut-off value for LA reservoir strain in predicting composite clinical outcomes.Patients with an LA strain <8.25% exhibited a significantly increased risk of composite clinical outcomes.In contrast, the estimated glomerular filtration rate showed a trend towards risk association but lacked statistical significance.Conclusions: LA reservoir strain, particularly <8.25%, is a significant echocardiographic predictor of clinical outcomes in patients with persistent AF and metabolic syndrome.This finding highlights the potential of LA reservoir strain as a valuable tool for risk stratification in this patient group.