房颤合并衰弱影响因素分析及肌少症与衰弱关联性OA

Objective To investigate independent risk factors for frailty in patients with atrial fibrillation(AF),to explore the impact of AF type and duration on frailty,and to examine the association between sarcopenia and frailty,thereby providing evidence for the prevention and management of frailty in AF patients.Methods A total of 136 patients with atrial fibrillation were enrolled.Frailty was assessed using the Fried frailty phenotype and patients were categorized into a frailty group(n=75)and a non-frailty group(n=61).Variables identified by univariate analysis were entered into a multivariate binary logistic regression model to determine independent influencing factors.Pearson chi-square test,linear-by-linear association chi-square test,and Spearman rank correlation were used to analyze the association be-tween AF type,AF composition,AF duration,and frailty.The relationship between sarcopenia and frailty was evaluated using Spearman rank correlation and receiver operating characteristic(ROC)curve analysis based on the SARC-F score.Results The prevalence of frailty among patients with atrial fibrillation was 55.15％.Multivariate analysis identified age,cardiac function class,B-type natriuretic peptide(BNP),D-dimer,left ventricular end-systolic diameter,SARC-F score,and Charlson Comorbidity Index as independent risk factors for frailty,with odds ratios ranging from 1.228 to 1.510.Serum albumin(ALB),left ventricular ejection fraction(LVEF),and Mini Nutritional Assessment-Short Form(MNA-SF)score were protective factors(OR＜1.0),showing a negative association with frailty.In AF subtype analy-sis,the proportion of persistent AF was significantly lower in the frailty group than in the non-frailty group(41.3％vs.65.6％,P＜0.05),whereas permanent AF was significantly more prevalent in the frailty group(49.3％vs.26.2％,P＜0.01).AF duration was significantly associated with frailty severity(contingency coefficient=0.554,x2=47.113,P＜0.01),and Spearman correlation confirmed a moderate positive correlation(r,=0.623,P＜0.05).The SARC-F score showed a moderate-to-strong positive correlation with frailty grade(r,=0.683,95％CI:0.442-0.802,P＜0.05).ROC analysis demonstrated that the SARC-F score had good predictive value for frailty(AUC=0.786,95％CI:0.695-0.877,P＜0.01).A cutoff value of 4.2 yielded a sensitivity of 0.723,specificity of 0.751,and an overall ac-curacy of approximately 75％.Conclusion Frailty is highly prevalent among patients with atrial fibrillation and is influ-enced by multiple clinical,cardiac,nutritional,and functional factors.Serum albumin,LVEF,and MNA-SF score act as protective factors against frailty.Sarcopenia is moderately to strongly associated with frailty,and a SARC-F score ≥4.2 provides good predictive value for frailty.Significant differences in frailty prevalence between persistent and permanent AF,as well as the positive correlation between AF duration and frailty,highlight the importance of timely rhythm control strategies,including pharmacological cardioversion,electrical cardioversion,and catheter ablation,to potentially reduce frailty risk.