{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:33:44Z","timestamp":1791650024746,"version":"4.3.4"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":125,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In transthyretin amyloid cardiomyopathy (ATTR-CM), reduced stroke volume (SV) portends a poor prognosis. Artificial intelligence (AI) enables rapid, standardized assessment of left ventricular outflow tract velocity-time integral (LVOT-VTI), which is a reliable surrogate for SV. We investigated longitudinal changes in AI-derived LVOT-VTI as outcome predictors in ATTR-CM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Consecutive patients with ATTR-CM underwent baseline and 12\u2009\u00b1\u20091 month transthoracic echocardiography between 2007 and 2021. Scans were processed by an AI platform for fully automated measurements including LVOT-VTI. Changes in echocardiographic variables were related to all-cause mortality in a landmark analysis using multivariable Cox models adjusting for clinical covariates (age, sex, TTR genotype, atrial fibrillation status, New York Heart Association class and National Amyloidosis Centre stage). Time-dependent receiver-operating characteristic analysis identified the optimal threshold of LVOT-VTI change. A total of 752 patients (74\u2009\u00b1\u20099\u2009years; 88% men; 66% wild-type) were followed for a median of 3.3\u2009years (interquartile range 2.1\u20135.0\u2009years), during which 334 (44.4%) died. Among changes in echocardiographic parameters over 12\u2009months, only LVOT-VTI change remained independently prognostic (adjusted hazard ratio [HR] per 1% decrease 0.994, p\u2009=\u20090.025). A \u22655% decrease (n\u2009=\u2009377 patients, 50%) independently predicted all-cause mortality (adjusted HR 1.41, 95% confidence interval 1.13\u20131.76; p\u2009=\u20090.003), and improved risk reclassification (integrated discrimination improvement\u2009=\u20090.012; continuous net reclassification improvement\u2009=\u20090.21, both p\u2009&amp;lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A \u22655% decrease of AI-derived LVOT-VTI over 12\u2009months, a simple indicator of SV loss, is independently associated with worse outcome in ATTR-CM. Routine monitoring of this automated AI metric may guide earlier therapeutic escalation and is a possible endpoint for future trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.70073","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T07:09:17Z","timestamp":1760598557000},"page":"3392-3400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Artificial Intelligence-Based Echocardiographic Assessment for Monitoring Disease Progression in Transthyretin Cardiac Amyloidosis"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2551-7403","authenticated-orcid":false,"given":"Lucia","family":"Venneri","sequence":"first","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Aimo","sequence":"additional","affiliation":[{"name":"Institute of Life Sciences, Scuola Superiore Sant'Anna , Pisa ,","place":["Italy"]},{"name":"Cardiology Division, Fondazione Toscana Gabriele Monasterio , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldostefano","family":"Porcari","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irem","family":"Sezer","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Ioannou","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awais","family":"Sheikh","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Mansell","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousuf","family":"Razvi","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surabhi Bhaskar","family":"Iyer","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Martinez-Naharro","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Bandera","sequence":"additional","affiliation":[{"name":"Cardiology Unit, IRCCS MultiMedica , Milan ,","place":["Italy"]},{"name":"Department for Biomedical Sciences for Health, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Chi","family":"Lim","sequence":"additional","affiliation":[{"name":"Us2.ai , Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Frost","sequence":"additional","affiliation":[{"name":"Us2.ai , Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Ezekowitz","sequence":"additional","affiliation":[{"name":"University of Alberta , Edmonton ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn S.P.","family":"Lam","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Moody","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital Birmingham , Birmingham ,","place":["UK"]},{"name":"Institute of Cardiovascular Sciences, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Whelan","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Lachmann","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh","family":"Wechelakar","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, Royal Free Hospital, London, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Emdin","sequence":"additional","affiliation":[{"name":"Institute of Life Sciences, Scuola Superiore Sant'Anna , Pisa ,","place":["Italy"]},{"name":"Cardiology Division, Fondazione Toscana Gabriele Monasterio , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip N.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"National 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