{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:15:18Z","timestamp":1772165718115,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Ministry of Science and Higher Education of the Russian Federation","award":["075-15-2022-301"],"award-info":[{"award-number":["075-15-2022-301"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Aortic stenosis (AS) is the most commonly diagnosed valvular heart disease, and its prevalence increases with the aging of the general population. However, AS is often diagnosed at a severe stage, necessitating surgical treatment, due to its long asymptomatic period. The objective of this study was to analyze the frequency of AS in a population of cardiovascular patients using echocardiography (ECHO) and to identify clinical factors and features associated with these patient groups. We utilized machine learning methods to analyze 84,851 echocardiograms performed between 2010 and 2018 at the National Medical Research Center named after V.A. Almazov. The primary indications for ECHO were coronary artery disease (CAD) and hypertension (HP), accounting for 33.5% and 14.2% of the cases, respectively. The frequency of AS was found to be 13.26% among the patients (n = 11,252). Within our study, 1544 patients had a bicuspid aortic valve (BAV), while 83,316 patients had a tricuspid aortic valve (TAV). BAV patients were observed to be younger compared to TAV patients. AS was more prevalent in the BAV group (59%) compared to the TAV group (12%), with a p-value of &lt;0.0001. By employing a machine learning algorithm, we randomly identified significant features present in AS patients, including age, hypertension (HP), aortic regurgitation (AR), ascending aortic dilatation (AscAD), and BAV. These findings could serve as additional indications for earlier observation and more frequent ECHO in specific patient groups for the earlier detection of developing AS.<\/jats:p>","DOI":"10.3390\/jpm13111588","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T10:19:27Z","timestamp":1699525167000},"page":"1588","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Analysis of Prevalence and Clinical Features of Aortic Stenosis in Patients with and without Bicuspid Aortic Valve Using Machine Learning Methods"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8656-3191","authenticated-orcid":false,"given":"Olga","family":"Irtyuga","sequence":"first","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2944-7607","authenticated-orcid":false,"given":"Mary","family":"Babakekhyan","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Kostareva","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Uspensky","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michail","family":"Gordeev","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5371-5761","authenticated-orcid":false,"given":"Giuseppe","family":"Faggian","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University of Verona Medical School, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Malashicheva","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oleg","family":"Metsker","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evgeny","family":"Shlyakhto","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6231-8036","authenticated-orcid":false,"given":"Georgy","family":"Kopanitsa","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Irtyuga, O., Kopanitsa, G., Kostareva, A., Metsker, O., Uspensky, V., Mikhail, G., Faggian, G., Sefieva, G., Derevitskii, I., and Malashicheva, A. (2022). Application of Machine Learning Methods to Analyze Occurrence and Clinical Features of Ascending Aortic Dilatation in Patients with and without Bicuspid Aortic Valve. J. Pers. Med., 12.","DOI":"10.3390\/jpm12050794"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: A population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1161\/CIRCULATIONAHA.119.043391","article-title":"Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990\u20132017","volume":"141","author":"Yadgir","year":"2020","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3515","DOI":"10.1093\/eurheartj\/ehw229","article-title":"Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: The OxVALVE Population Cohort Study","volume":"37","author":"Coffey","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Writing Committee Members, Otto, C.M., Nishimura, R.A., Bonow, R.O., Carabello, B.A., Erwin, J.P., Gentile, F., Jneid, H., Krieger, E.V., and Mack, M. (2021). 2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease. J. Am. Coll. Cardiol., 77, e25\u2013e197.","DOI":"10.1016\/j.jacc.2020.11.018"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1136\/hrt.2004.057117","article-title":"Aortic sclerosis: Not an innocent murmur but a marker of increased cardiovascular risk","volume":"91","author":"Nightingale","year":"2005","journal-title":"Heart"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1016\/j.jacc.2009.12.068","article-title":"Bicuspid Aortic Valve Disease","volume":"55","author":"Siu","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.ejcts.2006.12.006","article-title":"Predictors of ascending aortic dilatation with bicuspid aortic valve: A wide spectrum of disease expression","volume":"31","author":"Bancone","year":"2007","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.yjmcc.2019.07.010","article-title":"Patterns of ascending aortic dilatation and predictors of surgical replacement of the aorta: A comparison of bicuspid and tricuspid aortic valve patients over eight years of follow-up","volume":"135","author":"Agnese","year":"2020","journal-title":"J. Mol. Cell Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ccl.2019.09.008","article-title":"Sex Differences in the Pathophysiology, Diagnosis, and Management of Aortic Stenosis","volume":"38","author":"Clavel","year":"2020","journal-title":"Cardiol. Clin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100197","DOI":"10.1016\/j.ahjo.2022.100197","article-title":"Sex differences in aortic stenosis: Identification of knowledge gaps for sex-specific personalized medicine","volume":"21","author":"Iribarren","year":"2022","journal-title":"Am. Heart J. Plus Cardiol. Res. Pract."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e018816","DOI":"10.1161\/JAHA.120.018816","article-title":"Excess Mortality and Undertreatment of Women With Severe Aortic Stenosis","volume":"10","author":"Tribouilloy","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1161\/CIRCULATIONAHA.121.057639","article-title":"Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial","volume":"145","author":"Banovic","year":"2022","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.mayocp.2018.12.035","article-title":"Burden of Valvular Heart Diseases in Hispanic\/Latino Individuals in the United States: The Echocardiographic Study of Latinos","volume":"94","author":"Rubin","year":"2019","journal-title":"Mayo Clin. Proc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/14017431.2019.1685126","article-title":"Prevalence and risk factors of aortic stenosis and aortic sclerosis: A 21-year follow-up of middle-aged men","volume":"54","author":"Kontogeorgos","year":"2020","journal-title":"Scand. Cardiovasc. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.ehj.2003.12.002","article-title":"Mild and moderate aortic stenosis Natural history and risk stratification by echocardiography","volume":"25","author":"Rosenhek","year":"2004","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3414\/ME16-01-0057","article-title":"Integration of Hospital Information and Clinical Decision Support Systems to Enable the Reuse of Electronic Health Record Data","volume":"56","author":"Kopanitsa","year":"2017","journal-title":"Methods Inf. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_20","first-page":"2825","article-title":"Scikit-learn: Machine Learning in Python","volume":"12","author":"Pedregosa","year":"2011","journal-title":"J. Mach. Learn. Res."},{"key":"ref_21","unstructured":"Prokhorenkova, L., Gusev, G., Vorobev, A., Dorogush, A.V., and Gulin, A. (2018). Advances in Neural Information Processing Systems, Proceedings of the 32nd International Conference on Neural Information Processing Systems, Montr\u00e9al, QC, Canada, 3\u20138 December 2017, Curran Associates, Inc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.21105\/joss.03021","article-title":"Seaborn: Statistical data visualization","volume":"6","author":"Waskom","year":"2021","journal-title":"J. Open Source Softw."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1109\/MCSE.2007.55","article-title":"Matplotlib: A 2D Graphics Environment","volume":"9","author":"Hunter","year":"2007","journal-title":"Comput. Sci. Eng."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1613\/jair.953","article-title":"SMOTE: Synthetic Minority Over-sampling Technique","volume":"16","author":"Chawla","year":"2002","journal-title":"J. Artif. Intell. Res."},{"key":"ref_25","unstructured":"Lundberg, S.M., and Lee, S.I. (2017). Advances in Neural Information Processing Systems, Proceedings of the 31st Annual Conference on Neural Information Processing Systems (NIPS 2017), Long Beach, CA, USA, 4\u20139 December 2017, Curran Associates, Inc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1136\/heartjnl-2021-319697","article-title":"Incident aortic stenosis in 49 449 men and 42 229 women investigated with routine echocardiography","volume":"108","author":"Stewart","year":"2022","journal-title":"Heart"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"660797","DOI":"10.3389\/fcvm.2021.660797","article-title":"Dissecting Calcific Aortic Valve Disease\u2014The Role, Etiology, and Drivers of Valvular Fibrosis","volume":"8","author":"Feistner","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e005155","DOI":"10.1161\/CIRCIMAGING.116.005155","article-title":"Sex Differences in Phenotypes of Bicuspid Aortic Valve and Aortopathy: Insights From a Large Multicenter, International Registry","volume":"10","author":"Kong","year":"2017","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Palacios-Fernandez, S., Salcedo, M., Belinchon-Romero, I., Gonzalez-Alcaide, G., and Ramos-Rinc\u00f3n, J.M. (2022). Epidemiological and Clinical Features in Very Old Men and Women (\u226580 Years) Hospitalized with Aortic Stenosis in Spain, 2016\u20132019: Results from the Spanish Hospital Discharge Database. J. Clin. Med., 11.","DOI":"10.3390\/jcm11195588"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1253\/circj.CJ-16-1244","article-title":"Sex Differences in Severe Aortic Stenosis-Clinical Presentation and Mortality","volume":"81","author":"Toyofuku","year":"2017","journal-title":"Circ. J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/j.jcmg.2021.02.016","article-title":"Aortic Stenosis in Bicuspid and Tricuspid Valves: A Different Spectrum of the Disease With Clinical Implications","volume":"14","author":"Evangelista","year":"2021","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3351","DOI":"10.1093\/eurheartj\/ehx381","article-title":"Staging classification of aortic stenosis based on the extent of cardiac damage","volume":"38","author":"Pibarot","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/ehjci\/jeaa068","article-title":"Effect of bicuspid aortic valve phenotype on progression of aortic stenosis","volume":"21","author":"Shen","year":"2020","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1136\/heartjnl-2016-309916","article-title":"Contemporary natural history of bicuspid aortic valve disease: A systematic review","volume":"103","author":"Masri","year":"2017","journal-title":"Heart"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1136\/heartjnl-2020-318907","article-title":"Prognostic implications of left atrial dilation in aortic regurgitation due to bicuspid aortic valve","volume":"108","author":"Butcher","year":"2022","journal-title":"Heart"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"21340","DOI":"10.1038\/s41598-020-77286-6","article-title":"Multiscale classification of heart failure phenotypes by unsupervised clustering of unstructured electronic medical record data","volume":"10","author":"Nagamine","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ccl.2019.09.003","article-title":"Aortic Stenosis","volume":"38","author":"Harris","year":"2020","journal-title":"Cardiol. Clin."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/11\/1588\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:20:40Z","timestamp":1760131240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/11\/1588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":37,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["jpm13111588"],"URL":"https:\/\/doi.org\/10.3390\/jpm13111588","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,9]]}}}