{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:16:32Z","timestamp":1790342192585,"version":"4.1.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Left ventricular diastolic dysfunction (LVDD) is an early precursor to heart failure with preserved ejection fraction, and it is currently diagnosed using echocardiography, a resource-intensive and operator-dependent modality that limits large-scale screening. The 12-lead electrocardiogram (ECG) is widely available but lacks sufficient diagnostic accuracy for LVDD. Artificial intelligence (AI)\u2013enhanced ECG analysis has emerged as a potential scalable alternative, although its overall diagnostic performance remains uncertain. This study aims to evaluate the diagnostic accuracy of AI-based algorithms for detecting LVDD in a systematic review and meta-analysis. We systematically searched eight major databases through August 2025, complemented by forward and backward citation chasing. Studies reporting sensitivity and specificity of AI-ECG models, using echocardiography as the reference standard, were included. Pooled sensitivity, specificity, and area under the summary receiver operating characteristic curve (AUC) were estimated using a bivariate random-effects model. Five studies including 105 554 participants were analysed. AI-ECG demonstrated a pooled sensitivity of 0.82 (95% CI: 0.81\u20130.83) and specificity of 0.77 (95% CI: 0.70\u20130.82), with an AUC of 0.85 (95% CI: 0.81\u20130.87). Substantial heterogeneity was observed (I2 = 98.5% for sensitivity and 99.8% for specificity), although results were robust in sensitivity analyses. Predictive values were prevalence-dependent. Negative predictive value was 98.8% at 5% prevalence and 93.7% at 22.2%, but declined to 81.1% at 50% prevalence and 64.7% at 70%. Artificial intelligence\u2013enhanced electrocardiography demonstrated good diagnostic performance for detecting LVDD and may support future rule-out or risk-enrichment strategies in selected populations. However, current evidence remains insufficient to support routine clinical implementation.<\/jats:p>","DOI":"10.1093\/ehjdh\/ztag130","type":"journal-article","created":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T11:24:58Z","timestamp":1786879498000},"source":"Crossref","is-referenced-by-count":0,"title":["Artificial intelligence\u2013enabled electrocardiography for detection of left ventricular diastolic dysfunction: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"7","author":[{"given":"Johann","family":"Edjimbi","sequence":"first","affiliation":[{"name":"Alliance for Medical Research in Africa (AMedRA) , Dakar ,","place":["Senegal"]},{"name":"Department of Medicine, Sinai Hospital of Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0823-9169","authenticated-orcid":false,"given":"Nisarg","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yale School of Medicine, New Haven , CT ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7233-5901","authenticated-orcid":false,"given":"Luca","family":"Donisi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, European Georges Pompidou Hospital , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryan","family":"Gajjar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5331-4722","authenticated-orcid":false,"given":"Claudia","family":"See","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Francisco , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa A","family":"Grimshaw","sequence":"additional","affiliation":[{"name":"Harvey Cushing\/John Hay Whitney Medical Library, Yale University , New Haven, CT ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassim Bachir","family":"Diop","sequence":"additional","affiliation":[{"name":"Alliance for Medical Research in Africa (AMedRA) , Dakar ,","place":["Senegal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Luiz P","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais , Belo Horizonte ,","place":["Brazil"]},{"name":"Telehealth Center, Hospital das Cl\u00ednicas, Universidade Federal de Minas Gerais , Belo Horizonte ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7227-3428","authenticated-orcid":false,"given":"Eloi","family":"Marijon","sequence":"additional","affiliation":[{"name":"Alliance for Medical Research in Africa (AMedRA) , Dakar ,","place":["Senegal"]},{"name":"Division of Cardiology, European Georges Pompidou Hospital , Paris ,","place":["France"]},{"name":"Paris Cardiovascular Research Center (PARCC), INSERM U970, Universit\u00e9 Paris Cit\u00e9 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gari","family":"Clifford","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Emory University School of Medicine , Atlanta, GA ,","place":["USA"]},{"name":"Department of Biomedical Engineering, Georgia Institute of Technology , Atlanta, GA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5516-4665","authenticated-orcid":false,"given":"Bamba","family":"Gaye","sequence":"additional","affiliation":[{"name":"Alliance for Medical Research in Africa (AMedRA) , Dakar ,","place":["Senegal"]},{"name":"Paris Cardiovascular Research Center (PARCC), INSERM U970, Universit\u00e9 Paris Cit\u00e9 , Paris ,","place":["France"]},{"name":"Department of Biomedical Engineering, Georgia Institute of Technology , Atlanta, GA ,","place":["USA"]},{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University , Dakar ,","place":["Senegal"]},{"name":"Institute of Health and Development (ISED), Cheikh Anta Diop University , Dakar 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