{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T10:39:14Z","timestamp":1792579154663,"version":"4.5.0"},"reference-count":84,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"ERC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015999","name":"ORACLE","doi-asserted-by":"publisher","award":["ERC-2023-STG-101117469"],"award-info":[{"award-number":["ERC-2023-STG-101117469"]}],"id":[{"id":"10.13039\/100015999","id-type":"DOI","asserted-by":"publisher"}]},{"name":"COSMOS"},{"DOI":"10.13039\/501100007601","name":"European Union\u2019s Horizon 2020 research and innovation programme","doi-asserted-by":"publisher","award":["788960"],"award-info":[{"award-number":["788960"]}],"id":[{"id":"10.13039\/501100007601","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007601","name":"European Union\u2019s Horizon 2020 research and innovation programme","doi-asserted-by":"publisher","award":["957532"],"award-info":[{"award-number":["957532"]}],"id":[{"id":"10.13039\/501100007601","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Artificial intelligence (AI) is increasingly being applied in healthcare, including cardiology, with growing interest in its potential to support diagnosis, prognosis, and clinical decision-making. The rapid pace of technological advancements is not matched by equivalent progress in the regulation and appraisal of these systems. This review aims to provide a structured evidence map of AI models in cardiology, by grading the robustness of clinical validation and mapping it against the quantity of publications across main subspecialties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>To assess the strength of evidence, we defined, developed, and applied a novel classification tailored for AI models that ranks evidence into five Grades of Validation according to the level of clinical validity. We screened literature from 2014 to 2026 according to the PRISMA guidelines, identifying a total of 2807 articles on AI applications within cardiology, 490 of which met the inclusion criteria (validation was performed in at least one external, independent patient population), revealing a highly heterogeneous distribution of evidence across subspecialties. Most studies in AI focused on improved diagnostics (n = 322, 65.7%); however, advanced integration in prognostic (n = 122, 24.9%) and therapeutic applications remains limited (n = 46, 9.4%). Cardiovascular imaging leads AI applications, especially in coronary computed tomography and echocardiography, followed by non-invasive electrophysiology, predominantly in atrial fibrillation screening and ventricular dysfunction detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The scarcity of prospective validations across different resources and geographical settings (n = 134, 27.3%) and randomized controlled trials (n = 35, 3.8%) limits the adoption by clinical guidelines and widespread implementation of AI algorithms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztag152","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:10:00Z","timestamp":1789989000000},"source":"Crossref","is-referenced-by-count":0,"title":["Artificial intelligence in cardiology: an evidence map across subspecialties, 2014\u201326"],"prefix":"10.1093","volume":"7","author":[{"given":"\u0141ukasz","family":"Ko\u0142towski","sequence":"first","affiliation":[{"name":"1st Department of Cardiology, Medical University of Warsaw , Banacha 1A, 02-097 Warsaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miko\u0142aj","family":"Basza","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Medical University of Warsaw , Banacha 1A, 02-097 Warsaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Soli\u0144ski","sequence":"additional","affiliation":[{"name":"Computational Physics Laboratory, Tampere University , Tampere ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4837-5103","authenticated-orcid":false,"given":"Bartosz","family":"Rolek","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Medical University of Warsaw , Banacha 1A, 02-097 Warsaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Brandberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3097-2834","authenticated-orcid":false,"given":"Francesco","family":"Costa","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA) , M\u00e1laga ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]},{"name":"Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina , Messina ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurgul","family":"Keser","sequence":"additional","affiliation":[{"name":"Health Sciences University Faculty of Medicine, Department of Cardiology , Istanbul ,","place":["T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-3430","authenticated-orcid":false,"given":"Maria","family":"Marketou","sequence":"additional","affiliation":[{"name":"University of Crete, School of Medicine , Heraklion, Crete ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Grabowski","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Medical University of Warsaw , Banacha 1A, 02-097 Warsaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9944-8363","authenticated-orcid":false,"given":"Rafael","family":"Vidal-Perez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]},{"name":"Cardiac Imaging Unit, Complexo Hospitalario Universitario de A Coru\u00f1a (CHUAC) , A Coru\u00f1a ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0272-5617","authenticated-orcid":false,"given":"Nico","family":"Bruining","sequence":"additional","affiliation":[{"name":"Thorax Center, Department of Cardiology, Erasmus MC, Cardiovascular Institute , Rotterdam ,","place":["The 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,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0441-8976","authenticated-orcid":false,"given":"Pawe\u0142","family":"Balsam","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Medical University of Warsaw , Banacha 1A, 02-097 Warsaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Casado-Arroyo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H.U.B.\u2013H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareld","family":"Kemps","sequence":"additional","affiliation":[{"name":"Department of Cardiology, M\u00e1xima Medical Centre , Veldhoven ,","place":["The Netherlands"]},{"name":"Department of Industrial Design, Eindhoven University of Technology , Eindhoven ,","place":["The 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of Cardiology, Antwerp University Hospital , Antwerp ,","place":["Belgium"]},{"name":"Research Group Cardiovascular Diseases and Center for Research and Innovation in Care, University of Antwerp , Antwerp ,","place":["Belgium"]},{"name":"Faculty of Medicine and Life Sciences, Hasselt University , Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxandra","family":"Christodorescu","sequence":"additional","affiliation":[{"name":"Department V Internal Medicine, University of Medicine and Pharmacy Victor Babe\u0219 Timi\u0219oara, Research Centre, Institute of Cardiovascular Diseases Timi\u0219oara ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Opolski","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Medical University of Warsaw , Banacha 1A, 02-097 Warsaw 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