Trace element disturbances may influence the onset of atrial fibrillation (AF) in patients with VHD. A study published in Frontiers in Cardiovascular Medicine investigated urinary trace element levels in 144 patients, including 72 with VHD and AF and 72 with VHD alone, to assess their association with arrhythmia risk.

Patients with VHDAF demonstrated elevated manganese (Mn), Cu, and Hg levels and reduced Sr compared with those without AF. Quantile g-computation revealed a significant association between the mixture of 12 elements and AF (adjusted OR 2.05; 95% CI 1.18–3.57; p = 0.011). Copper carried the highest positive weight (0.43), followed by mercury (0.18), while strontium (−0.43) and lithium (−0.23) had the strongest negative influence.

These findings highlight the potential role of trace element imbalance in atrial remodeling and arrhythmia susceptibility among patients with structural heart disease. Further investigation may clarify whether modifying these mineral levels could support rhythm stability in valvular heart disease.