Jul 2026· Current Opinion in Cardiology· 0 citations· 68 references
Medicine
TL;DR
This review summarizes recent advances in the use of AI to facilitate diastolic function assessment and addresses limitations of AI including explainability, generalizability, regulatory considerations, and integration into clinical workflows.
Abstract
Purpose
OF REVIEW
Assessment of left ventricular diastolic function remains one of the most challenging aspects of echocardiography. Artificial intelligence (AI) has emerged as a transformative tool capable of automating data acquisition, analysis, and interpretation. This review summarizes recent advances in the use of AI to facilitate diastolic function assessment.
RECENT
Findings
An increasing number of studies have shown the potential for AI-based models to equal or exceed expert-guideline approaches for evaluating diastolic function while improving reproducibility and workflow. Recent trends include the use of more deep learning techniques, reliance on fewer input variables, validation with relevant clinical outcomes, and shift in diastolic function classification from a categorical grading system to a more continuous probabilistic score.
SUMMARY
Current guideline-based approaches integrate multiple Doppler, structural, and hemodynamic variables to classify diastolic function. Although these algorithms have improved standardization, they remain limited by interobserver variability, discordant parameters, indeterminate classifications, incomplete datasets, and reduced applicability in complex clinical settings. Machine learning and deep learning approaches can integrate multidimensional echocardiographic features, electrocardiographic signals, and clinical variables to identify latent physiologic patterns beyond conventional rule-based algorithms. Future work will focus on addressing limitations of AI including explainability, generalizability, regulatory considerations, and integration into clinical workflows.
Overall, AI-empowered echocardiography holds substantial promise for advancing precision diagnosis, risk stratification, and personalized management of HCM, facilitating a transition toward more intelligent and individualized cardiovascular care.
Miao Zhang, Shan-Shan Yuan, Hong-Yan Dai et al.· Frontiers in Cardiovascular...· 0 citations
Artificial intelligence (AI) is increasingly used in echocardiography and point-of-care ultrasound (POCUS) to support image acquisition, view recognition, image-quality assessment, segmentation, automated quantification, disease classification, reporting, and bedside decision support. This narrative review summarizes clinically relevant applications, with emphasis on clinical integration, pediatric and congenital heart disease considerations, and safe implementation. The strongest clinical evidence supports automated left ventricular segmentation and ejection fraction estimation, AI-guided acquisition, and workflow efficiency. Video-based deep learning has enabled beat-to-beat assessment of ventricular function, and a randomized workflow trial showed that AI-generated initial ejection fraction assessment was noninferior to sonographer assessment and required fewer cardiologist corrections. Regulatory-authorized acquisition and analysis tools demonstrate growing clinical adoption for specified adult indications. Recent multiview and disease-phenotyping models extend AI toward more comprehensive interpretation, while AI-enabled POCUS may improve focused image acquisition by non-expert users. However, external validation, pediatric and congenital heart disease data, cross-device generalizability, clinical outcome evidence, uncertainty communication, automation bias, and medicolegal responsibility remain important limitations. AI should currently be viewed as an augmentative rather than autonomous technology. The safest near-term model is human-AI collaboration, in which validated tools improve acquisition, reproducibility, and workflow while clinicians retain responsibility for interpretation and patient-centered decisions. Pediatric and congenital heart disease applications require age- and anatomy-specific datasets, multicenter validation, local performance monitoring, and clinician-supervised deployment. AI can assist across the echocardiography workflow, from acquisition guidance and view recognition to segmentation, quantification, disease screening, and structured reporting. The most mature clinical evidence supports left ventricular segmentation, ejection fraction estimation, AI-guided acquisition, and workflow efficiency rather than autonomous diagnosis. AI-enabled POCUS may improve acquisition by non-expert users, but image adequacy, interpretation, and clinical integration must remain clinician-supervised. Pediatric and congenital heart disease applications are promising but remain less mature than adult applications and require anatomy-specific datasets and multicenter validation. Safe implementation requires external validation, local monitoring, bias assessment, uncertainty display, audit trails, and institutional governance.
F. Savorgnan, Pranathi Pilla, Sarah Visokay et al.· Current Pediatrics Reports· 0 citations
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.
Zhihong Wen, Xiang-Peng Liu, Yi Liu et al.· iScience· 0 citations
The role of AI-enhanced cardiovascular ultrasound in the transition from descriptive imaging toward predictive and personalized medicine is examined, with AI-enhanced cardiovascular ultrasound poised to become a central tool of precision cardiology.
Ancuța Elena Țupu, Simona Steliana Tudor, C. Dumitru et al.· Journal of Clinical Medicine· 0 citations
This review evaluates current evidence, identifies existing gaps, and outlines the requirements for responsible clinical implementation of AI in echocardiography.
R. Heo, Seung-Ah Lee, Hyuk-Jae Chang· Journal of Cardiovascular Im...· 0 citations
Importance
Timely identification of aortic stenosis (AS) is essential for appropriate clinical management, yet screening remains limited by dependence on comprehensive echocardiography and trained imaging personnel.
Objective
To develop and validate a deep learning algorithm for detection of moderate or greater AS and prospectively evaluate its performance using artificial intelligence (AI)-guided focused cardiac ultrasound (FoCUS) acquired by novice operators.
Design, Setting, and Participants
This diagnostic study included retrospective algorithm development and validation and prospective evaluation of AI-guided FoCUS across Mayo Clinic sites in the Midwest, Arizona, and Florida. The model was developed using 6753 patients and evaluated in internal validation (n = 852), internal test (n = 844), and validation (n = 1912) cohorts. Performance was assessed on FoCUS acquired by experienced sonographers (n = 602) and prospectively by novice operators (n = 1302). The retrospective model development and validation cohorts comprised studies performed from January 2005 through September 2022. Prospective study was conducted in 2 enrollment periods from June to August 2024 and from June to September 2025. Participants from both periods were combined to comprise the final prospective cohort.
Exposure
AI-guided FoCUS acquisition and automated deep learning-based assessment for detection of moderate or greater AS.
Main Outcomes and Measures
Detection of moderate or greater AS. Performance was assessed using area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and positive predictive value.
Results
The model demonstrated excellent discrimination in the internal test cohort (AUROC, 0.99; 95% CI, 0.98-1.00) and geographically distinct validation cohorts in Arizona (AUROC, 0.99; 95% CI, 0.97-1.00) and Florida (AUROC, 0.99; 95% CI, 0.96-1.00). Among FoCUS examinations acquired by experienced sonographers, sensitivity was 95% (95% CI, 82-99) and specificity was 97% (95% CI, 95-98). In the prospective novice-operator cohort, 1258 of 1302 examinations (96.6%) were suitable for automated analysis. Sensitivity was 93% (95% CI, 82-99) and specificity was 96% (95% CI, 95-97). Expert review of AI-positive and uninterpretable examinations increased the positive predictive value from 49.4% to 91.1%, with sensitivity of 85.4%.
Conclusions and Relevance
A deep learning algorithm accurately detected moderate or greater AS across validation cohorts in this study. In prospective evaluation, novice operators were able to acquire AI-guided FoCUS examinations that enabled accurate detection of moderate or greater AS. These findings support a scalable strategy that may expand access to AS detection in settings with limited echocardiography resources.
Eunjung Lee, J. Naser, Conor J. Kane et al.· JAMA cardiology· 1 citation
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