DeepCard is a multi-task deep learning system that produces standardized, reproducible interpretation of pre-measured echocardiographic parameters by jointly analyzing 39 quantitative measurements across 17 diagnostic tasks spanning valvular disease, ventricular dysfunction, and structural abnormalities.
Abstract
Summary Echocardiographic interpretation underlies a large share of cardiovascular diagnoses, yet specialist expertise remains unevenly distributed, and quantitative measurements show inter-observer variability of 15–17% that contributes to disagreement in borderline cases. We developed DeepCard, a multi-task deep learning system that produces standardized, reproducible interpretation of pre-measured echocardiographic parameters by jointly analyzing 39 quantitative measurements across 17 diagnostic tasks spanning valvular disease, ventricular dysfunction, and structural abnormalities. Trained on 400 patients, DeepCard reached 91% specificity for valvular assessment and 82% accuracy for ventricular evaluation, and reduced inter-observer interpretive variability for pre-measured parameters to 13.4%. On an independent external cohort of 102 patients from a separate institution, performance decreased by only 2.6%, indicating consistent generalization. By providing standardized interpretation of quantitative measurements, DeepCard may help clinicians achieve more consistent and reproducible cardiac assessment, particularly in settings where specialist availability is limited.
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BACKGROUND
Accurate assessment of left ventricular outflow tract (LVOT) gradients is critical for hypertrophic cardiomyopathy management, yet Doppler-based measurements are technically demanding and require expertise. The objective of this work was to develop a multi-view deep learning model capable of classifying LVOT obstruction (>20 mm Hg) using routine 2-dimensional echocardiographic windows without reliance on Doppler imaging.
METHODS
We trained and externally validated a cross-attention-based video-to-video fusion framework that integrated EchoPrime-derived video representations from 3 standard transthoracic echocardiographic views to classify LVOT gradients.
RESULTS
Training was performed on a derivation cohort (N=1833) from a tertiary care system in the United States, with model performance evaluated on an internally held-out test set (N=275) and a Korean external validation cohort (N=46). Single-view baselines showed limited discrimination (external area under the receiver operating curves, 0.47-0.70). Conversely, the domain-specific foundational model (EchoPrime) achieved superior single-view performance (area under the receiver operating curves, 0.75-0.80 internal; 0.79-0.83 external), highlighting the importance of echo-specific pretraining and temporal modeling. The proposed multi-view fusion further enhanced predictive performance, with the late fusion model reaching an area under the receiver operating curve of 0.84 on the external cohort with significant population-shift.
CONCLUSIONS
These results suggest LVOT physiology is encoded in routine 2-dimensional imaging and can be leveraged for clinically relevant gradient classification without Doppler input. The proposed artificial intelligence-guided strategy demonstrates substantial cost savings compared with the screen-all approach. By integrating complementary spatial-temporal information across multiple views, our approach generalizes robustly across populations and may enable real-time decision support, extend LVOT assessment to portable or resource-limited settings, and complement Doppler-based evaluation for longitudinal hypertrophic cardiomyopathy management.
O. Crystal, J. Farina, I. Scalia et al.· Circulation Cardiovascular I...· 0 citations
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