Heart failure & cardiomyopathies
Associations of Electromechanical Activation Time With Cardiac Structure and Function and Clinical Outcomes
Authors' conclusion
In a community cohort, an increased EMAT was associated with a lower LVEF and adverse prognosis but had poor discriminatory capacity for the former and was not independent of NT-proBNP for the latter.
Study context
- Population
- Community participants in Dallas Heart Study-2 with acoustic cardiography, CMR and blood sampling at baseline
- Participants
- 3,401 participants
- Exposure
- Electromechanical activation time (EMAT) vs NT-proBNP for cardiovascular (CV) screening
- Outcome
- Discrimination for reduced LVEF (<55%) by C-statistics
Methodological detailscommunity-based
- Community-based
Main finding
As reported in the abstract
Discrimination for reduced LVEF (<55%)
EMAT
0.52
C-statistic
NT-proBNP
0.59
C-statistic
P < 0.01
- EMAT did not improve discrimination beyond NT-proBNP alone
- P = 0.90
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| CV death/HF hospitalization · median follow-up 12.4 yearsAdjusted for age, race, sex | 1.3 (1.2–1.4) | P < 0.001 | |
| Major adverse clinical events (CV death, HF hospitalization, nonfatal MI, stroke, AF) · median follow-up 12.4 yearsAdjusted for age, race, sex | 1.2 (1.1–1.4) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
- CV death/HF hospitalization — Not significant after additional adjustment for NT-proBNP
- P > 0.10
- Major adverse clinical events (CV death, HF hospitalization, nonfatal MI, stroke, AF) — Not significant after additional adjustment for NT-proBNP
- P > 0.10
Cardiac structure and function (continuous EMAT)
- Higher EMAT independently associated with lower left ventricular ejection fraction (LVEF)
- P < 0.001
- Higher EMAT independently associated with greater LV end-diastolic volume
- P = 0.04
Original publication
Associations of Electromechanical Activation Time With Cardiac Structure and Function and Clinical Outcomes. JACC Adv. Published 27 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it