Metabolic Signatures of Atrial Functional Impairment in Paroxysmal Atrial Fibrillation Patients: A CMR...

Atrial fibrillation (AF) is the most common clinical arrhythmia. Patients with paroxysmal atrial fibrillation (PAF) may exhibit reversible changes in atrial function at an early stage. Identifying biomarkers for this stage is crucial for delaying disease progression. This study integrated cardiac magnetic resonance (CMR) atrial strain analysis with untargeted metabolomics. Despite similar left atrial sizes, significant differences in atrial strain were observed among PAF patients. Seven differential metabolites-phosphatidylcholine, inosine, bilirubin, biliverdin, 3-methylhistidine, L-tryptophan, and pantothenic acid-were identified as potential biomarkers associated with declining atrial function. These findings suggest that peripheral blood metabolites are associated with atrial functional impairment in PAF patients. However, these exploratory findings warrant further investigation in larger prospective cohorts.