{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:02:22Z","timestamp":1776384142122,"version":"3.51.2"},"reference-count":38,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Asia"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.jacasi.2025.11.019","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T04:27:18Z","timestamp":1769833638000},"page":"451-462","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Biological Age Acceleration and All-Cause Mortality in Moderate to Severe Aortic Valve Stenosis"],"prefix":"10.1016","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4841-7714","authenticated-orcid":false,"given":"Yiqi","family":"Zheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinghao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2658-9258","authenticated-orcid":false,"given":"Zhenyu","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bingzhen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menghui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingfeng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaozhao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rihua","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodong","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinxue","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"4","key":"10.1016\/j.jacasi.2025.11.019_bib1","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1161\/ATVBAHA.119.313067","article-title":"Aortic valve stenosis: from basic mechanisms to novel therapeutic targets","volume":"40","author":"Goody","year":"2020","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"16","key":"10.1016\/j.jacasi.2025.11.019_bib2","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1161\/CIRCULATIONAHA.110.006767","article-title":"Calcific aortic valve disease: not simply a degenerative process: a review and agenda for research from the National Heart and Lung and Blood Institute Aortic Stenosis Working Group. Executive summary: calcific aortic valve disease\u20142011 update","volume":"124","author":"Rajamannan","year":"2011","journal-title":"Circulation"},{"issue":"15","key":"10.1016\/j.jacasi.2025.11.019_bib3","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1016\/j.jacc.2019.08.004","article-title":"Poor long-term survival in patients with moderate aortic stenosis","volume":"74","author":"Strange","year":"2019","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"10.1016\/j.jacasi.2025.11.019_bib4","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1016\/j.jacc.2020.11.018","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"77","author":"Otto","year":"2021","journal-title":"J Am Coll Cardiol"},{"issue":"22","key":"10.1016\/j.jacasi.2025.11.019_bib5","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1016\/j.jacc.2018.08.2146","article-title":"5-year outcomes of self-expanding transcatheter versus surgical aortic valve replacement in high-risk patients","volume":"72","author":"Gleason","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"10.1016\/j.jacasi.2025.11.019_bib6","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1161\/CIRCRESAHA.118.312816","article-title":"Time and the metrics of aging","volume":"123","author":"Ferrucci","year":"2018","journal-title":"Circ Res"},{"issue":"4","key":"10.1016\/j.jacasi.2025.11.019_bib7","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1111\/acel.12601","article-title":"Molecular and physiological manifestations and measurement of aging in humans","volume":"16","author":"Khan","year":"2017","journal-title":"Aging Cell"},{"issue":"6","key":"10.1016\/j.jacasi.2025.11.019_bib8","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1136\/heartjnl-2012-302265","article-title":"The evolving epidemiology of valvular aortic stenosis. the Troms\u00f8 study","volume":"99","author":"Eveborn","year":"2013","journal-title":"Heart"},{"issue":"9540","key":"10.1016\/j.jacasi.2025.11.019_bib9","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: a population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet"},{"issue":"1","key":"10.1016\/j.jacasi.2025.11.019_bib10","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1136\/heartjnl-2023-322709","article-title":"Traditional and novel risk factors for incident aortic stenosis in community-dwelling older adults","volume":"110","author":"Massera","year":"2023","journal-title":"Heart"},{"issue":"2","key":"10.1016\/j.jacasi.2025.11.019_bib11","doi-asserted-by":"crossref","DOI":"10.1111\/acel.13080","article-title":"Measuring biological aging in humans: a quest","volume":"19","author":"Ferrucci","year":"2020","journal-title":"Aging Cell"},{"key":"10.1016\/j.jacasi.2025.11.019_bib12","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.66223","article-title":"Unite to predict","volume":"10","author":"Kothari","year":"2021","journal-title":"Elife"},{"issue":"2","key":"10.1016\/j.jacasi.2025.11.019_bib13","doi-asserted-by":"crossref","first-page":"303","DOI":"10.18632\/aging.101684","article-title":"DNA methylation GrimAge strongly predicts lifespan and healthspan","volume":"11","author":"Lu","year":"2019","journal-title":"Aging (Albany NY)"},{"key":"10.1016\/j.jacasi.2025.11.019_bib14","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.54870","article-title":"Quantification of the pace of biological aging in humans through a blood test, the DunedinPoAm DNA methylation algorithm","volume":"9","author":"Belsky","year":"2020","journal-title":"Elife"},{"issue":"3","key":"10.1016\/j.jacasi.2025.11.019_bib15","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.mad.2005.10.004","article-title":"A new approach to the concept and computation of biological age","volume":"127","author":"Klemera","year":"2006","journal-title":"Mech Ageing Dev"},{"issue":"4","key":"10.1016\/j.jacasi.2025.11.019_bib16","doi-asserted-by":"crossref","first-page":"573","DOI":"10.18632\/aging.101414","article-title":"An epigenetic biomarker of aging for lifespan and healthspan","volume":"10","author":"Levine","year":"2018","journal-title":"Aging (Albany NY)"},{"issue":"6","key":"10.1016\/j.jacasi.2025.11.019_bib17","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1093\/gerona\/gls233","article-title":"Modeling the rate of senescence: can estimated biological age predict mortality more accurately than chronological age?","volume":"68","author":"Levine","year":"2013","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"12","key":"10.1016\/j.jacasi.2025.11.019_bib18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002718","article-title":"A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: a cohort study","volume":"15","author":"Liu","year":"2018","journal-title":"PLoS Med"},{"key":"10.1016\/j.jacasi.2025.11.019_bib19","doi-asserted-by":"crossref","DOI":"10.1016\/j.ebiom.2024.105494","article-title":"Accelerated biological aging increases the risk of short- and long-term stroke prognosis in patients with ischemic stroke or TIA","volume":"111","author":"Wang","year":"2025","journal-title":"EBioMedicine"},{"issue":"11","key":"10.1016\/j.jacasi.2025.11.019_bib20","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afae245","article-title":"Clinical biomarker-based biological ageing and the risk of adverse outcomes in patients with chronic kidney disease","volume":"53","author":"Xiang","year":"2024","journal-title":"Age Ageing"},{"issue":"3","key":"10.1016\/j.jacasi.2025.11.019_bib21","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1038\/s44161-024-00438-8","article-title":"Accelerated biological aging elevates the risk of cardiometabolic multimorbidity and mortality","volume":"3","author":"Jiang","year":"2024","journal-title":"Nat Cardiovasc Res"},{"key":"10.1016\/j.jacasi.2025.11.019_bib22","doi-asserted-by":"crossref","DOI":"10.1016\/j.ebiom.2023.104458","article-title":"Modeling biological age using blood biomarkers and physical measurements in Chinese adults","volume":"89","author":"Chen","year":"2023","journal-title":"EBioMedicine"},{"issue":"4","key":"10.1016\/j.jacasi.2025.11.019_bib23","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.echo.2017.02.009","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"30","author":"Baumgartner","year":"2017","journal-title":"J Am Soc Echocardiogr"},{"issue":"7","key":"10.1016\/j.jacasi.2025.11.019_bib24","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur Heart J"},{"issue":"6","key":"10.1016\/j.jacasi.2025.11.019_bib25","doi-asserted-by":"crossref","first-page":"2795","DOI":"10.1007\/s11357-021-00480-5","article-title":"A toolkit for quantification of biological age from blood chemistry and organ function test data: BioAge","volume":"43","author":"Kwon","year":"2021","journal-title":"Geroscience"},{"issue":"24","key":"10.1016\/j.jacasi.2025.11.019_bib26","doi-asserted-by":"crossref","first-page":"3316","DOI":"10.1161\/CIRCULATIONAHA.104.486738","article-title":"Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies","volume":"111","author":"Freeman","year":"2005","journal-title":"Circulation"},{"issue":"1","key":"10.1016\/j.jacasi.2025.11.019_bib27","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13148-024-01647-5","article-title":"Epigenetic age acceleration and risk of aortic valve stenosis: a bidirectional mendelian randomization study","volume":"16","author":"Pan","year":"2024","journal-title":"Clin Epigenetics"},{"issue":"39","key":"10.1016\/j.jacasi.2025.11.019_bib28","doi-asserted-by":"crossref","first-page":"3596","DOI":"10.1093\/eurheartj\/ehy486","article-title":"Elevated blood pressure and risk of aortic valve disease: a cohort analysis of 5.4 million UK adults","volume":"39","author":"Rahimi","year":"2018","journal-title":"Eur Heart J"},{"issue":"22","key":"10.1016\/j.jacasi.2025.11.019_bib29","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1136\/heartjnl-2022-320897","article-title":"Diabetes mellitus and cardiovascular mortality across the spectrum of aortic stenosis","volume":"108","author":"Coisne","year":"2022","journal-title":"Heart"},{"issue":"19","key":"10.1016\/j.jacasi.2025.11.019_bib30","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.017190","article-title":"Severe aortic stenosis and chronic kidney disease: outcomes and impact of aortic valve replacement","volume":"9","author":"Bohbot","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"5","key":"10.1016\/j.jacasi.2025.11.019_bib31","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1093\/cvr\/cvab161","article-title":"Senescence mechanisms and targets in the heart","volume":"118","author":"Chen","year":"2022","journal-title":"Cardiovasc Res"},{"issue":"3","key":"10.1016\/j.jacasi.2025.11.019_bib32","doi-asserted-by":"crossref","first-page":"671","DOI":"10.3390\/cells9030671","article-title":"Immune clearance of senescent cells to combat ageing and chronic diseases","volume":"9","author":"Song","year":"2020","journal-title":"Cells"},{"issue":"9","key":"10.1016\/j.jacasi.2025.11.019_bib33","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1161\/CIRCRESAHA.121.318011","article-title":"Inflammatory and biomechanical drivers of endothelial-interstitial interactions in calcific aortic valve disease","volume":"128","author":"Driscoll","year":"2021","journal-title":"Circ Res"},{"issue":"3","key":"10.1016\/j.jacasi.2025.11.019_bib34","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1093\/eurheartj\/ehn501","article-title":"Reduced number and function of endothelial progenitor cells in patients with aortic valve stenosis: a novel concept for valvular endothelial cell repair","volume":"30","author":"Matsumoto","year":"2009","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacasi.2025.11.019_bib35","doi-asserted-by":"crossref","DOI":"10.1016\/j.carpath.2021.107318","article-title":"Cellular senescence evaluated by P16INK4a immunohistochemistry is a prevalent phenomenon in advanced calcific aortic valve disease","volume":"52","author":"Oh","year":"2021","journal-title":"Cardiovasc Pathol"},{"issue":"20","key":"10.1016\/j.jacasi.2025.11.019_bib36","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1136\/bjsports-2022-106503","article-title":"Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials","volume":"57","author":"Edwards","year":"2023","journal-title":"Br J Sports Med"},{"issue":"5","key":"10.1016\/j.jacasi.2025.11.019_bib37","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/MNH.0000000000000627","article-title":"Advances in exercise therapy in predialysis chronic kidney disease, hemodialysis, peritoneal dialysis, and kidney transplantation","volume":"29","author":"Wilkinson","year":"2020","journal-title":"Curr Opin Nephrol Hypertens"},{"issue":"7","key":"10.1016\/j.jacasi.2025.11.019_bib38","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/eurheartj\/ehae406","article-title":"Wearable device\u2013measured moderate to vigorous physical activity and risk of degenerative aortic valve stenosis","volume":"46","author":"Li","year":"2025","journal-title":"Eur Heart J"}],"container-title":["JACC: Asia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772374725007069?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772374725007069?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T23:16:13Z","timestamp":1776381373000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2772374725007069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["S2772374725007069"],"URL":"https:\/\/doi.org\/10.1016\/j.jacasi.2025.11.019","relation":{},"ISSN":["2772-3747"],"issn-type":[{"value":"2772-3747","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Biological Age Acceleration and All-Cause Mortality in Moderate to Severe Aortic Valve Stenosis","name":"articletitle","label":"Article Title"},{"value":"JACC: Asia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacasi.2025.11.019","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.","name":"copyright","label":"Copyright"}]}}