{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T09:13:31Z","timestamp":1776417211925,"version":"3.51.2"},"reference-count":3,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Symptomatic aortic stenosis (AS) constitutes a class I indication for aortic valve intervention, either by surgical or transcatheter aortic valve replacement (TAVR). Progressive AS can reduce maximal oxygen consumption (MVO2), yet this parameter is not routinely evaluated in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We present a case of a 68-year-old with hypertension and hyperlipidaemia, initially diagnosed with moderate AS [aortic valve area (AVA) 1.3\u2005cm2, mean gradient 23\u2005mmHg, peak velocity 3.2\u2005m\/s]. He was asymptomatic and maintained a high level of physical activity, including treadmill running. Over the course of 3 years, the patient used an Apple Watch\u00ae to monitor estimated VO2 max. Despite stable exercise tolerance, his recorded VO2 max decreased progressively from 36 to 26\u2005mL\/kg\/min. Concerned by the trend, he sought our evaluation. Repeat echocardiography showed severe AS (AVA 0.6\u2005cm2, mean gradient 43\u2005mmHg, peak velocity 4.29\u2005m\/s) with preserved left ventricular ejection fraction (LVEF 60%\u201365%). The patient subsequently underwent TAVR with a 26\u2005mm Edwards Lifesciences Sapien 3 Ultra Valve\u00ae. At 1-year follow-up, his Apple Watch\u2013derived VO2 max improved to 41\u2005mL\/kg\/min. Echocardiography confirmed a well-seated prosthesis with a mean gradient of 9\u2005mmHg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates the potential utility of consumer wearable technology (Apple Watch) for detecting progressive asymptomatic AS using estimated VO2 max feature. Continuous tracking of estimated VO2 max may serve as an adjunct parameter to guide timing of intervention in selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag246","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:37:14Z","timestamp":1774957034000},"source":"Crossref","is-referenced-by-count":0,"title":["Detection of progression of asymptomatic severe aortic stenosis using Apple Watch\u2013estimated maximal oxygen consumption (VO2 max): a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2980-063X","authenticated-orcid":false,"given":"Mukhtar","family":"Al-Saadi","sequence":"first","affiliation":[{"name":"Department of Cardiology, HCA Houston\/University of Houston College of Medicine , 1200 Binz St., Houston, TX 77004 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5411-4762","authenticated-orcid":false,"given":"Aswin","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, HCA Houston\/University of Houston College of Medicine , 1200 Binz St., Houston, TX 77004 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Langlois","sequence":"additional","affiliation":[{"name":"Structural Heart & Valve Center, Houston Heart, HCA Houston Healthcare Medical Center, The University of Houston Medical School , 1200 Binz St., Suite 900, Houston, TX 77004 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranav","family":"Loyalka","sequence":"additional","affiliation":[{"name":"Structural Heart & Valve Center, Houston Heart, HCA Houston Healthcare Medical Center, The University of Houston Medical School , 1200 Binz St., Suite 900, Houston, TX 77004 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"2026041704184180100_ytag246-B1","doi-asserted-by":"crossref","first-page":"e0323741","DOI":"10.1371\/journal.pone.0323741","article-title":"Investigating the accuracy of apple watch VO2 max measurements: a validation study","volume":"20","author":"Lambe","year":"2025","journal-title":"PLoS One"},{"key":"2026041704184180100_ytag246-B2","author":"Apple Inc"},{"key":"2026041704184180100_ytag246-B3","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"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag246\/67932011\/ytag246.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag246\/68102222\/ytag246.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag246\/68102222\/ytag246.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:18:55Z","timestamp":1776413935000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag246\/8626082"}},"subtitle":[],"editor":[{"given":"Mohammad","family":"El Tahlawi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mohammed Shahbaaz","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mohammad","family":"El Tahlawi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":3,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag246","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,4,1]]},"article-number":"ytag246"}}