{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:17Z","timestamp":1790586017613,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Accurate non\u2010invasive assessment of left ventricular diastolic dysfunction and filling pressures is central to the diagnosis and management of heart failure, particularly heart failure with preserved ejection fraction (HFpEF). Despite widespread use of transthoracic echocardiography, guideline\u2010based algorithms are frequently indeterminate, variably reproducible, and difficult to apply consistently in routine practice. Artificial intelligence (AI) has emerged as a potential strategy to standardize measurement, integrate multiparametric echocardiographic data, and reduce diagnostic uncertainty. We performed a systematic review of diagnostic accuracy studies evaluating AI or machine\u2010learning approaches applied to echocardiography for automated assessment of diastolic function or estimation of left ventricular filling pressures. Databases were searched from inception to July 7, 2026. Reference standards included invasive hemodynamics or guideline\u2010based diastolic classification. Risk of bias and applicability were assessed using QUADAS\u20103. Fourteen studies were included, with development samples and validation or test cohorts reported separately. Validation ranged from small held\u2010out invasive cohorts to large independent external datasets. Against invasive hemodynamic reference standards, reported AUCs ranged from 0.761 to 0.883, reflecting heterogeneous hemodynamic targets, thresholds, and validation designs. Studies evaluating agreement with guideline\u2010 or expert\u2010derived classifications and automated replication of individual diastolic parameters generally reported high discrimination, although these represented distinct clinical tasks and varied substantially in the independence and scale of validation. Several studies demonstrated external or prospective validation, but robust evaluation against invasive hemodynamics remained limited. Given substantial methodological and clinical heterogeneity, findings were synthesized descriptively and no summary estimate was calculated. Despite promising diagnostic discrimination in retrospective studies, AI\u2010based echocardiographic diastolic assessment remains limited by heterogeneous reference standards, variable validation approaches, and an absence of prospective interventional clinical\u2010impact studies and limited prospective multicenter validation against invasive hemodynamics, precluding routine implementation at this stage.<\/jats:p>","DOI":"10.1111\/echo.70630","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:57:49Z","timestamp":1790150269000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Artificial Intelligence\u2013Based Echocardiographic Assessment of Diastolic Dysfunction: A Systematic Review"],"prefix":"10.1111","volume":"43","author":[{"given":"Cian P.","family":"Murray","sequence":"first","affiliation":[{"name":"Cardiology Department Waterford University Hospital  Waterford Leinster Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo C.","family":"Temperley","sequence":"additional","affiliation":[{"name":"Trinity College Dublin Trinity Translational Medicine Institute  Dublin Leinster Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob S.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Cardiology Department Mater Misericordiae University Hospital  Dublin Leinster Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullahi","family":"Khair","sequence":"additional","affiliation":[{"name":"Cardiology Department Waterford University Hospital  Waterford Leinster Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Jagiello","sequence":"additional","affiliation":[{"name":"Cardiology Department Waterford University Hospital  Waterford Leinster Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"John","sequence":"additional","affiliation":[{"name":"Cardiology Department Waterford University Hospital  Waterford Leinster Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"O'Callaghan","sequence":"additional","affiliation":[{"name":"Cardiology Department Waterford University Hospital  Waterford Leinster Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.2020"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.11.011"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2305181"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.05.032"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-025-10516-z"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.15345"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-020-02069-z"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2025.03.011"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.10.068"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2025.07.053"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.8731"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERP\u201018\u20100056"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(21)00235-1"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2023.105124"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt-24-25"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jead231"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.05.003"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2024.10.019"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2021.04.010"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.70290"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt-24-128"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.07.001"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2024.132504"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2022.06.005"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeag025"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12574\u2010026\u201000738\u2010x"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS\u201025\u201002104"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.010637"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1621"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2023.100452"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70630","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.70630","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70630","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:44:09Z","timestamp":1790585049000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.70630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/echo.70630"],"URL":"https:\/\/doi.org\/10.1111\/echo.70630","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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