{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T08:50:54Z","timestamp":1792313454294,"version":"4.4.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Artificial intelligence (AI)\u2013enabled electrocardiography has emerged as a tool for detecting cardiac dysfunction. The prognostic relevance of AI\u2010enabled electrocardiography\u2013derived diastolic dysfunction (DD) in patients undergoing transcatheter aortic valve replacement had not been assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed 3197 patients undergoing transcatheter aortic valve replacement for severe aortic stenosis between 2010 and 2023 with baseline 12\u2010lead ECGs processed by a validated AI model to classify diastolic function (grades 0\u20133). Multivariable Cox models and nested model comparisons assessed associations with all\u2010cause mortality, including a prespecified analysis in patients with indeterminate echocardiographic grading. Trajectories were defined by change in AI\u2010enabled electrocardiography DD grade (&lt;2 versus \u22652) from baseline to 30\u2010day or 1\u2010year follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      At baseline, 21% had grade 3, 57% had grade 2, 8% had grade 1, and 14% had grade 0 AI\u2010enabled electrocardiography DD. Higher grades were associated with adverse cardiac remodeling and comorbidities. Over a median follow\u2010up of 3.4\u2009years, grade 3 AI\u2010enabled electrocardiography DD independently predicted mortality (hazard ratio [HR], 1.80 [95% CI, 1.47\u20132.20];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). AI\u2010enabled electrocardiography DD improved prognostic discrimination beyond clinical and echocardiographic measures (\u0394Harrell concordance statistic, 0.016; \u0394\n                      <jats:italic toggle=\"no\">\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =57;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Among 1259 patients with indeterminate echocardiographic grading, AI\u2010enabled electrocardiography added prognostic value (\u0394Harrell concordance statistic, 0.02; \u0394\n                      <jats:italic toggle=\"no\">\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =13;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006). Worsening or persistently high\u2010risk trajectories were associated with increased mortality (HRs, 1.45\u20131.80; all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">AI\u2010enabled electrocardiography\u2013derived DD independently predicts mortality after transcatheter aortic valve replacement, adds value beyond echocardiographic grading, and enables dynamic risk stratification through longitudinal tracking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046558","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T10:15:58Z","timestamp":1769768158000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic Value of Artificial Intelligence\u2013Enabled Electrocardiography\u2013Derived Diastolic Dysfunction Grading and Trajectory in Patients Undergoing Transcatheter Aortic Valve Replacement"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8052-6664","authenticated-orcid":false,"given":"Chieh\u2010Mei","family":"Tsai","sequence":"first","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6210-7669","authenticated-orcid":false,"given":"Jwan A.","family":"Naser","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4234-6504","authenticated-orcid":false,"given":"Gal","family":"Tsaban","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-9527","authenticated-orcid":false,"given":"Eunjung","family":"Lee","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Wood","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9821-1225","authenticated-orcid":false,"given":"Allen S.","family":"Luis","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4489-2349","authenticated-orcid":false,"given":"Jeremy J.","family":"Thaden","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garvan C.","family":"Kane","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5256-3150","authenticated-orcid":false,"given":"Sorin V.","family":"Pislaru","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9465-8150","authenticated-orcid":false,"given":"Trevor J.","family":"Simard","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1044-0750","authenticated-orcid":false,"given":"Kevin L.","family":"Greason","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-5379","authenticated-orcid":false,"given":"Mackram F.","family":"Eleid","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6095-5579","authenticated-orcid":false,"given":"Vuyisile T.","family":"Nkomo","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8303-5780","authenticated-orcid":false,"given":"Jae K.","family":"Oh","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2022.12.006"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.10.032"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.000636"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.shj.2023.100225"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-311506"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021165"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.10.038"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00993-7"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.06.054"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.0595"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.125.018353"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew082"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.018"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.12.006"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.06.004"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2025.10.065"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.18632\/aging.205835"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.05.034"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.123.012033"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjdh\/ztad009"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw096"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2021.08.024"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.668681"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.054"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjdh\/ztae022"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-22877-8"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-024-06922-4"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1974"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf362"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.009355"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.121.057480"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.120.008176"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025554"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2009.05.002"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.08.025"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2015.04.026"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2021.02.029"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-018-0240-2"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.101234"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2024.1934"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ibmed.2022.100062"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.046558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:54:49Z","timestamp":1784112889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.046558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,2,3]]}},"alternative-id":["10.1161\/JAHA.125.046558"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.046558","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]},"assertion":[{"value":"2025-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e046558"}}