{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:29:28Z","timestamp":1793608168925,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Existing risk stratification models are insufficient in identifying patients at high risk for heart failure (HF) hospitalization, particularly among those presenting with symptomatic aortic stenosis and the HF with preserved ejection fraction phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This multicenter cohort study enrolled 321 patients diagnosed with severe aortic stenosis and HF with preserved ejection fraction who underwent transcatheter aortic valve replacement between January 2017 and February 2024. Various predictive modeling techniques were used, including random forest, XGBoost, SuperPC, plsRcox, least absolute shrinkage and selection operator\u2013Cox, Gradient Boosting Machine, Coxboost, and Cox regression analysis, at multiple time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients were divided into a derivation cohort (n=191) and an external validation cohort (n=130) based on institutional affiliation, with a median follow\u2010up of 20 months. Feature selection using the Boruta algorithm and least absolute shrinkage and selection operator regression, combined with variance inflation factor analysis to assess multicollinearity, identified 6 independent predictors. Among 8 prediction models evaluated, the Cox regression\u2013based nomogram demonstrated superior performance in external validation, achieving time\u2010dependent area under the curve values of 0.824 (95% CI, 0.693\u20130.956) at 12 months and 0.818 (95% CI, 0.715\u20130.920) at 20 months. The nomogram exhibited excellent calibration and substantial clinical utility across both time points, consistently outperforming the European System for Cardiac Operative Risk Evaluation in discrimination and reclassification analyses. An interactive web\u2010based clinical decision support tool was developed to facilitate point\u2010of\u2010care implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This nomogram, based on machine learning and incorporating metabolic biomarkers, exhibits high predictive accuracy for HF hospitalization in patients with symptomatic aortic stenosis and high\u2010risk HF with preserved ejection fraction phenotype following transcatheter aortic valve replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique Identifier: ChiCTR2400092655.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046606","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:38:17Z","timestamp":1773139097000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Development and Validation of a Prognostic Nomogram for Post\u2013Transcatheter Aortic Valve Replacement Heart Failure Hospitalization in Patients With Concurrent Symptomatic Aortic Stenosis and Heart Failure With Preserved Ejection Fraction: A Multicenter Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7863-0331","authenticated-orcid":false,"given":"Jun","family":"Wang","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]},{"name":"Bengbu Medical University","place":["Bengbu, China"]},{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]},{"name":"Scientific and Technical Information (STI)\u2010Zhilian Research Institute for Innovation and Digital Health","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5281-4619","authenticated-orcid":false,"given":"Shoupeng","family":"Duan","sequence":"additional","affiliation":[{"name":"Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9579-1921","authenticated-orcid":false,"given":"Hui","family":"Li","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shili","family":"Wu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]},{"name":"The People\u2019s Hospital of Bozhou","place":["Bozhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4588-032X","authenticated-orcid":false,"given":"Peng","family":"Zhao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7932-4950","authenticated-orcid":false,"given":"Tongjian","family":"Zhu","sequence":"additional","affiliation":[{"name":"Xiangyang Central Hospital","place":["Xiangyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengxing","family":"Tang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0714-8579","authenticated-orcid":false,"given":"Jiajun","family":"Zhu","sequence":"additional","affiliation":[{"name":"the First Affiliated Hospital of Xinjiang Medical University","place":["Urumchi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6059-6713","authenticated-orcid":false,"given":"Bi","family":"Tang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]},{"name":"Bengbu Medical University","place":["Bengbu, China"]},{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1799-2708","authenticated-orcid":false,"given":"Jinjun","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]},{"name":"Bengbu Medical University","place":["Bengbu, China"]},{"name":"The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]},{"name":"Scientific and Technical Information (STI)\u2010Zhilian Research Institute for Innovation and Digital Health","place":["Beijing, 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guidelines for the diagnosis and treatment of heart failure 2023","volume":"7","author":"National Center for Cardiovascular Diseases, Heart Failure Committee of National Expert Committee on Cardiovascular Diseases, Heart Failure Committee of Chinese Medical Doctor Association, Editorial Board of Chinese Journal of Heart Failure and Cardiomyopathy","year":"2023","unstructured":"National Center for Cardiovascular Diseases, Heart Failure Committee of National Expert Committee on Cardiovascular Diseases, Heart Failure Committee of Chinese Medical Doctor Association, Editorial Board of Chinese Journal of Heart Failure and Cardiomyopathy . Chinese guidelines for the diagnosis and treatment of heart failure 2023. 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