Valvular & structural heart disease
Electromechanical Window Negativity and Arrhythmic Risk in Arrhythmogenic Mitral Valve Prolapse
Authors' conclusion
EMW is markedly negative in patients with AMVP/VA, reflecting electromechanical discordance. Thus, EMW emerges as a promising risk-associated marker in (A)MVP.
Study context
- Population
- Healthy controls and patients with mitral valve prolapse with or without ventricular arrhythmiaderivation cohort plus validation cohort · derivation cohort: controls 31 · derivation cohort: Mitral valve prolapse (MVP)/-VA 31 · derivation cohort: AMVP/nsVA 29 · derivation cohort: AMVP/VA 14 · validation cohort (with [A]MVP) 76
- Participants
- 31 / 31 / 29 / 14
- Exposure
- Electromechanical window (EMW) inMVP vs controls, and as a marker identifying AMVP/VA
- controlsn = 31
- MVP/-VAn = 31
- AMVP/nsVAn = 29
- AMVP/VAn = 14
Methodological details3 centers (derivation cohort), independent validation cohort from 2 centers, EMW calculated blinded
- 3 centers (derivation cohort)
- Independent validation cohort from 2 centers
- EMW calculated blinded
Main finding
As reported in the abstract
QAoCc, QTc and EMW, (A)MVP vs controls
(A)MVP
−18
range in brackets −47 to −8 ms · ms
- Borderline shorter QAoCc than controls
- P = 0.06
- Significantly longer QTc than controls
- P < 0.0001
- More negative EMW than controls
- P < 0.0001
Observational data: associations, not effects.
Further findings
- EMW in AMVP/VA
- −71 · range in brackets −177 to −30 ms · ms
EMW in AMVP/VA
- EMW was most negative in patients with AMVP/VA
Validation cohort
- Findings reproduced in the validation cohort, albeit at different absolute values
EMW identifying AMVP/VA (pooled ROC analysis)
- Area under the curve
- 0.82 (95% CI: 0.73-0.91)
- Optimal cutoff EMW threshold
- −30 ms
- Sensitivity
- 0.71
- Specificity
- 0.83
- Significantly outperforming QTc and QAoCc
EMW and AMVP/VA status
- EMW independently associated with AMVP/VA status and improved model performance in addition to established risk parameters
Original publication
Electromechanical Window Negativity and Arrhythmic Risk in Arrhythmogenic Mitral Valve Prolapse. JACC Cardiovasc Imaging. Published 16 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it