{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:44Z","timestamp":1791355964736,"version":"4.3.1"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Diastolic dysfunction is common in patients with aortic stenosis and may influence outcomes following surgical aortic valve replacement. We aimed to examine the association of preoperative artificial intelligence (AI)\u2010generated diastolic function grades with early and late outcomes following aortic valve replacement and how postoperative progression influence prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We identified 5503 patients undergoing aortic valve replacement between 2000 and 2023. Diastolic function was assessed using a validated deep\u2010learning AI model applied to 12\u2010lead ECGs done preoperatively and on postoperative follow\u2010up. Diastolic grades were classified by AI into Grades 1 to 3. Longitudinal trend analyses and multivariable regression models were used to assess study end points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 5503 patients (mean age 72.4\u00b110.8\u2009years; 39% female), higher AI ECG diastolic grades were associated with greater comorbidity burden, including diabetes, renal disease, and heart failure. AI ECG diastolic Grade 3 was independently associated with higher in\u2010hospital mortality (odds ratio, 2.5;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.007) and other complications. At 5\u2010year follow\u2010up, patients with Grade 3 showed the least improvement in diastolic function by both ECG and echocardiography. Grades 2 and 3 diastolic function at baseline were independently associated with increased late mortality (hazard ratio, 1.3 and 2.45, respectively; both\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Additionally, lack of improvement in AI ECG diastolic grade by 1 year was also independently associated with late mortality.\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 ECG\u2013derived diastolic function grades strongly correlates with early complications and long\u2010term mortality and diastolic progression after aortic valve replacement. AI ECG provides a powerful, noninvasive tool for risk stratification and longitudinal monitoring of patients with aortic stenosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.050492","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:24:10Z","timestamp":1788150250000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of Artificial Intelligence ECG\u2013Derived Diastolic Function in Surgical Aortic Valve Replacement"],"prefix":"10.1161","volume":"15","author":[{"given":"Tedy","family":"Sawma","sequence":"first","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0994-027X","authenticated-orcid":false,"given":"Hartzell V.","family":"Schaff","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, 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