Artificial intelligence-enhanced echocardiography in cardiovascular disease management

Peder L Myhre^#^{1

2

3}, Bjørnar Grenne^#^{4

5}, Federico M Asch⁶, Victoria Delgado⁷, Rohan Khera^{8

9

10

11

12}, Stéphane Lafitte^{13

14}, Roberto M Lang¹⁵, Patricia A Pellikka¹⁶, Partho P Sengupta¹⁷, Sreekanth Vemulapalli^{18

19}, Carolyn S P Lam^{20

21}

Affiliations

¹ K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
² Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
³ Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.
⁴ Department of Circulation and Medical Imaging, NTNU: Norwegian University of Science and Technology, Trondheim, Norway.
⁵ Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.
⁶ MedStar Health Research Institute and Georgetown University, Washington, DC, USA.
⁷ Heart Institute, University Hospital Germans Trias i Pujol, Badalona, Spain.
⁸ Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
⁹ Section of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
¹⁰ Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA.
¹¹ Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.
¹² Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, CT, USA.
¹³ Bordeaux University, Bordeaux, France.
¹⁴ Unité médico-chirurgicale des valvulopathies, CHU Bordeaux, Bordeaux, France.
¹⁵ University of Chicago Medical Center, Chicago, IL, USA.
¹⁶ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
¹⁷ Division of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
¹⁸ Division of Cardiology, Duke University School of Medicine, Durham, NC, USA.
¹⁹ Duke Clinical Research Institute, Durham, NC, USA.
²⁰ National Heart Centre, Singapore and Duke-National University of Singapore, Singapore, Singapore. Carolyn.lam@duke-nus.edu.sg.
²¹ Baim Institute for Clinical Research, Harvard Medical School, Boston, MA, USA. Carolyn.lam@duke-nus.edu.sg.

^# Contributed equally.

PMID: 40764834
DOI: 10.1038/s41569-025-01197-0

Review

Artificial intelligence-enhanced echocardiography in cardiovascular disease management

Peder L Myhre et al. Nat Rev Cardiol. 2025.

. 2025 Aug 5.

doi: 10.1038/s41569-025-01197-0. Online ahead of print.

Authors

Affiliations

¹ K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
² Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
³ Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.
⁴ Department of Circulation and Medical Imaging, NTNU: Norwegian University of Science and Technology, Trondheim, Norway.
⁵ Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.
⁶ MedStar Health Research Institute and Georgetown University, Washington, DC, USA.
⁷ Heart Institute, University Hospital Germans Trias i Pujol, Badalona, Spain.
⁸ Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
⁹ Section of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
¹⁰ Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA.
¹¹ Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.
¹² Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, CT, USA.
¹³ Bordeaux University, Bordeaux, France.
¹⁴ Unité médico-chirurgicale des valvulopathies, CHU Bordeaux, Bordeaux, France.
¹⁵ University of Chicago Medical Center, Chicago, IL, USA.
¹⁶ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
¹⁷ Division of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
¹⁸ Division of Cardiology, Duke University School of Medicine, Durham, NC, USA.
¹⁹ Duke Clinical Research Institute, Durham, NC, USA.
²⁰ National Heart Centre, Singapore and Duke-National University of Singapore, Singapore, Singapore. Carolyn.lam@duke-nus.edu.sg.
²¹ Baim Institute for Clinical Research, Harvard Medical School, Boston, MA, USA. Carolyn.lam@duke-nus.edu.sg.

^# Contributed equally.

PMID: 40764834
DOI: 10.1038/s41569-025-01197-0

Abstract

Artificial intelligence (AI) is transforming echocardiography, ushering in an era of improved diagnostic precision, efficiency and patient care. In this Review, we present an in-depth exploration of AI applications in echocardiography, highlighting the latest advances, practical implementations and future directions. We discuss the integration of AI throughout the echocardiographic workflow, from image acquisition and analysis to interpretation. We outline the potential of AI to automate routine measurements and calculations, enable task shifting, recognize disease-specific patterns and uncover new phenogroups that might surpass current diagnostic classifications. Moreover, we address the aspects needed to create trustworthy AI systems, through careful validation, navigating regulatory requirements and upholding ethical standards, thereby presenting a balanced perspective on the advantages and limitations of this rapidly evolving technology. Through an examination of current AI applications, clinical studies and technological breakthroughs, we offer a comprehensive understanding of the evolving role of AI in the future of echocardiography and its capacity to advance cardiovascular care, while also acknowledging the current limitations of the widespread clinical implementation of AI-supported echocardiography.

PubMed Disclaimer

Conflict of interest statement

Competing interests: P.L.M. has received research grants from AstraZeneca and consulting fees from Amarin, AmGen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Novartis, Novo Nordisk, Orion Pharma, Pharmacosmos, Vifor and Us2.ai. B.G. has received consultant or speaker fees from Bayer, AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Novartis and Pfizer, and holds a position at the Centre for Innovative Ultrasound Solutions (CIUS), a Norwegian Research Council centre for research-based innovation, in which GE HealthCare is a consortium partner. F.M.A. reports institutional research contracts with Abbott, Ancora Heart, Boston Scientific, Croivalve, Edwards Lifesciences, egnite, GE HealthCare, InnovHeart, InterShunt, LAMINAR, Medtronic, Neovasc, TOMTEC, Tricares, Ultromics, Us2.ai, VDyne and Xeltis. V.D. received speaker fees from Abbott Structural, Edwards Lifesciences, GE HealthCare, JenaValve, Medtronic, Philips, Siemens and Products&Features, and received consulting fees from Edwards Lifesciences, MSD and Novo Nordisk. R.K. is an associate editor of JAMA; receives support from the National Heart, Lung, and Blood Institute of the National Institutes of Health (awards R01HL167858, R01AG089981 and K23HL153775), the Doris Duke Charitable Foundation (award 2022060) and the Blavatnik Family Foundation; receives research support through Yale University from BridgeBio, Bristol Myers Squibb and Novo Nordisk; is a coinventor of US pending patent applications WO2023230345A1, US20220336048A1, 63/346,610, 63/484,426, 63/508,315, 63/580,137, 63/606,203, 63/619,241, 63/562,335 and 18/813,882; and is a co-founder of Ensight-AI and Evidence2Health, which are health platforms to improve cardiovascular diagnosis and evidence-based cardiovascular care. P.A.P. is editor-in-chief of the Journal of the American Society of Echocardiography; is supported as the Betty Knight Scripps–George M. Gura, Jr., MD Professor of Cardiovascular Diseases Clinical Research at Mayo Clinic; and receives research support from the National Heart, Lung, and Blood Institute of the National Institutes of Health and through Mayo Clinic from Edwards Lifesciences and Ultromics. P.P.S. has received grants from the National Heart, Lung, and Blood Institute (award 1R01HL173998-01A1) and National Science Foundation (award 2125872). He has served on the Advisory Board of HeartSciences and RCE Technologies and holds stock options; has received grants or contracts from Butterfly, HeartSciences, MindMics and RCE Technologies; and holds patents with Mayo Clinic (US8328724B2), HeartSciences (US11445918B2) and Rutgers Health (62/864,771, US202163152686P, WO2022182603A1, US202163211829P, WO2022266288A1 and US202163212228P). S.V. reports grants and/or contracts from Abbott Vascular, the American College of Cardiology, the National Heart Lung and Blood Institute (R01HL168940-01A1, R01HL141213-03, U24HL165029-02 and U24HL171356-01A1), Boston Scientific, Cytokinetics, Edwards Lifesciences and the Food and Drug Administration, and has served as an advisory board member, consultant or speaker for Abbott Vascular, the American College of Physicians, AstraZeneca, Boehringer Ingelheim, Cytokinetics, Edwards Lifesciences, HeartFlow, JenaValve, Ikon, Medtronic, Medscape and Total CME. C.S.P.L. is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from Novo Nordisk and Roche Diagnostics; has served as consultant or on the advisory board, steering committee or executive committee for Alnylam Pharma, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Biopeutics, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Corteria, CPC Clinical Research, Eli Lilly, Impulse Dynamics, Intellia Therapeutics, Ionis Pharmaceutical, Janssen Research & Development LLC, Medscape/WebMD Global LLC, Merck, Novartis, Novo Nordisk, Quidel Corporation, Radcliffe Group, Roche and Us2.ai; and serves as co-founder and non-executive director of Us2.ai (US patent no. 10,702, 247). The other authors declare no competing interests.

References

1. Lang, R. M. et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr. 28, 1–39.e14 (2015). - PubMed
1. Thorstensen, A., Dalen, H., Amundsen, B. H., Aase, S. A. & Stoylen, A. Reproducibility in echocardiographic assessment of the left ventricular global and regional function, the HUNT study. Eur. J. Echocardiogr. 11, 149–156 (2010). - PubMed
1. Nagueh, S. F. et al. Interobserver variability in applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 guidelines for estimation of left ventricular filling pressure. Circ. Cardiovasc. Imaging 12, e008122 (2019). - PubMed
1. Won, D. et al. Sound the alarm: the sonographer shortage is echoing across healthcare. J. Ultrasound Med. 43, 1289–1301 (2024). - PubMed
1. Hanneman, K. et al. Value creation through artificial intelligence and cardiovascular imaging: a scientific statement from the American Heart Association. Circulation 149, e296–e311 (2024). - PubMed

Publication types

Actions

LinkOut - more resources

Full Text Sources
- Nature Publishing Group

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Artificial intelligence-enhanced echocardiography in cardiovascular disease management

Affiliations

Artificial intelligence-enhanced echocardiography in cardiovascular disease management

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

LinkOut - more resources

Full Text Sources