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Review
. 2025 Oct 27;18(20):2439-2457.
doi: 10.1016/j.jcin.2025.08.031.

Artificial Intelligence in Valvular Heart Disease: Innovations and Future Directions

Annette Maznyczka  1 , Rutger-Jan Nuis  2 , Isaac Shiri  3 , Julien Ternacle  4 , Philippe Garot  5 , Mark M P van den Dorpel  6 , Arif A Khokhar  7 , Raffaele De Lucia  8 , Michele Orini  9 , Shelby Kutty  10 , Julia Grapsa  11 , Christoph Gräni  12 , Ambarish Pandey  13 , Taylor Becker  14 , Kevin O'Gallagher  15 , Peter Mortier  16 , Lakshmi Prasad Dasi  17 , Klaus Fuglsang Kofoed  18 , Sandy Engelhardt  19 , Patric Biaggi  20 , Faraz S Ahmad  21 , Dee Dee Wang  22 , Lionel Leroux  4 , Thomas Modine  4 , Stephan Windecker  3 , Rebecca T Hahn  23 , Nicolas M Van Mieghem  2 , Ole De Backer  24
Affiliations
Review

Artificial Intelligence in Valvular Heart Disease: Innovations and Future Directions

Annette Maznyczka et al. JACC Cardiovasc Interv. .

Abstract

Managing valvular heart disease (VHD) requires integrating multimodal data, including demographics, symptoms, biomarkers, electrocardiogram findings, and imaging studies. However, the capacity and processing power of the human mind are limited, particularly in the current era where vast quantities of complex data require rapid processing. Integrating artificial intelligence (AI) into the management of VHD offers an opportunity to enhance diagnostic accuracy, streamline clinical workflows, optimize procedural strategies, and predict outcomes and disease progression. Subsets of AI such as machine learning and deep learning algorithms can uncover the unseen data from routine investigations (eg, electrocardiograms, echocardiography, and computed tomography), providing robust and accurate risk prediction tools to inform personalized treatment strategies. Intraprocedurally, AI-based enhancements in imaging guidance can be leveraged to improve procedural safety and success. Digital twin technology can allow case-specific disease modelling, such as simulating valve designs and predicting adverse events, fostering precision medicine. By using the full potential of AI, clinicians can provide a comprehensive, personalized management strategy for VHD patients, ultimately enhancing clinical outcomes. However, models based on AI algorithms require rigorous validation across multiple centers to ensure their reliability. Concerns about bias, data privacy, and limited transparency challenge the application of AI decision-making to digital health care. This review discusses the applications of AI in the management of patients with VHD, highlights the future directions of AI technologies, and considers the challenges of integrating AI into clinical practice.

Keywords: artificial intelligence; digital twin; fusion imaging; multi-modality imaging; valvular heart disease.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Maznyczka has received travel grants from Edwards Lifesciences, Abbott, Boston Scientific, and Medtronic. Dr Nuis has received research grant support from Vifor Pharma and Meril; and has received consulting fees from Edwards Lifesciences, Abbott, and Boston Scientific. Dr Ternacle is a consultant for Edwards Lifesciences, Abbott, GE, and Philips Healthcare. Dr Garot has received speaker/advisory fees from Abbott, Boston Scientific, Biosensors, Edwards Lifesciences, and Terumo; and is the medical director and shareholder of CERC (Cardiovascular European Research Center). Dr Khokhar has received speaker fees from Abbott, Boston Scientific, and Medtronic. Dr Gräni has received funding from the Swiss National Science Foundation, InnoSuisse, Center for Artificial Intelligence in Medicine University Bern, GAMBIT Foundation, Novartis Foundation for Medical-Biological Research, Swiss Heart Foundation, and the Bangerter-Rhyner-Foundation, outside of the submitted work; and serves as editor-in-chief of The International Journal of Cardiovascular Imaging (Springer). Dr Mortier is a cofounder of FEops. Dr Becker is a consultant for DASI Simulations and has patents pending on computational modeling. Dr Dasi is a stakeholder in DASI Simulations; and has a patent pending as coinventor of patents related to computational predictive modeling of heart valves. Dr Kofoed has received research grants from AP Møller og hustru Chastine McKinney Møllers Fond, Novo Nordisk Foundation, Novo Nordic A/S, Sygeforsikringen Danmark, Research Council of Rigshospitalet, The University of Copenhagen, Canon Medical Systems, and GE Healthcare. Dr Biaggi is a proctor for Abbott and Edwards Lifesciences; is a consultant for Philips Healthcare; and has institutional consulting contracts with Edwards Lifesciences and Philips Healthcare for which he has received no direct compensation. Dr Wang has served as a consultant for Abbott, Boston Scientific, and Edwards Lifesciences; and has received institutional research grant support from Boston Scientific. Dr Leroux has been a physician proctor for Medtronic and Abbott; and a consultant for Edwards Lifesciences. Dr Modine has served as a consultant for Abbott, Edwards Lifesciences, and Medtronic. Dr Windecker has received institutional research, travel, or educational grants from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Braun, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Cordis Medical, CorFlow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Farapulse Inc., Fumedica, Guerbet, Idorsia, Inari Medical, InfraRedx, Janssen-Cilag, Johnson & Johnson, MedAlliance, Medicure, Medtronic, Merck Sharp & Dohme, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pharming Tech, Pfizer, Polares, Regeneron, Sanofi, Servier, Sinomed, Terumo, Vifor, and V-Wave; has served as advisory board member and/or member of the steering/executive groups for trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, and V-Wave without personal payments; and is a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact to his personal remuneration. Dr Hahn has received speaker fees from Abbott Structural, Baylis Medical, Edwards Lifesciences, Medtronic, and Philips Healthcare; has institutional consulting contracts with Abbott Structural, Edwards Lifesciences, Medtronic, and Novartis; and is the chief scientific officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored tricuspid valve trials, for which she receives no direct industry compensation. Dr Van Mieghem has received grant support/research contracts from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Teleflex, Daiichi-Sankyo, AstraZeneca, and PulseCath BV; and has received consulting/speaker fees from Abbott Vascular, Boston Scientific Corporation, Medtronic, Daiichi Sankyo, Teleflex, PulseCath BV, JenaValve, Anteris, and Amgen. Dr De Backer has received institutional research grants and personal consulting fees from Abbott, Boston Scientific, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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