Unsupervised clustering of patients with severe aortic stenosis: A myocardial continuum

Artificial Intelligence in the Screening, Diagnosis, and Management of Aortic Stenosis

“…[ 94 ] found that the discriminative power of cluster analysis was based on identifying the inherent yet obscure irreversibility of cardiac dysfunction (and therefore poor prognosis), rather than the obvious characteristics at baseline. further studies support the use of risk stratification using unsupervised cluster analysis [ 18 , 19 , 27 , 95 , 96 ]. In addition to clinical outcomes, Sengupta et al .…”

“…AI application has enabled the full automation of primary AS evaluation [ 12 , 26 ]. AI algorithms successfully merge echocardiographic data with pertinent clinical information, allowing for the identification of distinct sub-phenotypes among patients with clinically severe AS, a task difficult to achieve through conventional statistical methods or current AS knowledge [ 17 , 27 ]. Another potential application in AS management that has been met with considerable enthusiasm is the use of AI to assist or automate the planning process for TAVR [ 24 , 28 ].…”

“…Patients who clustered in the severe phenotype had a higher aortic valve calcium score, greater ventricular mass, and more cardiac fibrosis [ 19 ]. It is worth noting that the high-severity phenotype identified by cluster analysis is often associated with cardiac dysfunction and other structural abnormalities [ 17 , 18 , 19 , 27 , 95 , 96 ]. Together, these AI-generated results highlight that AS is more of a “myocardial continuum” with sequential upstream damage, rather than an isolated structural condition.…”

Added value of heart valve clinics in the management of asymptomatic aortic stenosis

“…Late referral exposes to an increased risk of intervention when they are performed in patients with severe symptoms. Late referral may also compromise late results of intervention due to more extensive remodelling and damage of the myocardium 4. Although it has been shown that a heart valve clinic was useful for improving the follow-up of asymptomatic patients with AS,5 clinical outcome according to different follow-up modalities has not been studied so far.…”