Comparison of Artificial Intelligence-Driven Echocardiographic Assessment of Diastolic Function With the ASE Guidelines
Authors' conclusion
In settings where not all guideline-recommended parameters are available, the DL model may improve prognostic and diagnostic performance compared with both guideline versions. Nevertheless, these exploratory findings require further validation to confirm that the observed advantages persist when all guideline-recommended parameters are systematically acquired.
Study context
- Population
- ARIC (Atherosclerosis Risk In Communities) cohort and hemodynamic validation cohorts from the United States and Japan, in which ≥1 guideline-recommended parameters were unavailable in a substantial proportion of patientsper cohort · ARIC cohort 5,450 · United States hemodynamic validation cohort 83 · Japanese hemodynamic validation cohort 130
- Index test or model
- DL model vs 2016 ASE/EACVI and 2025 ASE guidelines for diagnosing elevated left ventricular filling pressure (hemodynamic validation cohorts) and for prognostication (ARIC cohort)
- Target condition
- elevated left ventricular filling pressure
Methodological detailsexploratory, 3 cohorts: ARIC cohort for prognostication; 2 hemodynamic validation cohorts (United States, Japan) for diagnosis
- Exploratory
- 3 cohorts: ARIC cohort for prognostication; 2 hemodynamic validation cohorts (United States, Japan) for diagnosis
Performance
As reported in the abstract
| Test or model | AUC |
|---|---|
| DL model | 0.879 |
| 2025 ASE guidelines | 0.822 |
| 2016 ASE/EACVI guidelines | 0.812 |
AUC
DL model0.879
2025 ASE guidelines0.822
2016 ASE/EACVI guidelines0.812
- DL model vs 2025 ASE guidelines: P = 0.041 — higher AUC with DL model
- DL model vs 2016 ASE/EACVI guidelines: P = 0.138 — similar AUC
Further findings
| Outcome | DL model | 2016 ASE/EACVI guidelines | 2025 ASE guidelines |
|---|---|---|---|
| Prognostication, C-index — ARIC cohort | |||
| C-index | 0.676 | 0.638 | 0.602 |
| Elevated left ventricular filling pressure, AUC — Japanese cohort | |||
| AUC | 0.816 | 0.694 | 0.634 |
- Prognostication, C-index — ARIC cohort: DL model higher than both guidelines: both P < 0.001
- Elevated left ventricular filling pressure, AUC — Japanese cohort: DL model higher than both guideline versions: both P < 0.05
Original publication
Comparison of Artificial Intelligence-Driven Echocardiographic Assessment of Diastolic Function With the ASE Guidelines. JACC Adv. Published September 2026. doi:10.
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