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The Role of Artificial Intelligence in Echocardiography

  • Echocardiography (JM Gardin and AH Waller, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Echocardiography is an indispensable tool in diagnostic cardiology and is fundamental to clinical care. Significant advances in cardiovascular imaging technology paralleled by rapid growth in electronic medical records, miniaturized devices, real-time monitoring, and wearable devices using body sensor network technology have led to the development of complex data.

Recent Findings

The intricate nature of these data can be overwhelming and exceed the capabilities of current statistical software. Machine learning (ML), a branch of artificial intelligence (AI), can help health care providers navigate through this complex labyrinth of information and unravel hidden discoveries. Furthermore, ML algorithms can help automate several tasks in echocardiography and clinical care.

Summary

ML can serve as a valuable diagnostic tool for physicians in the field of echocardiography. In addition, it can help expand the capabilities of research and discover alternative pathways in medical management. In this review article, we describe the role of AI and ML in echocardiography.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Shameer K, Johnson KW, Glicksberg BS, Dudley JT, Sengupta PP. Machine learning in cardiovascular medicine: are we there yet? Heart. 2018;104(14):1156–64.

    Article  Google Scholar 

  2. Shrestha S, Sengupta PP. The mechanics of machine learning: from a concept to value. J Am Soc Echocardiogr. 2018;31(12):1285–7.

    Article  Google Scholar 

  3. Seetharam K, Kagiyama N, Sengupta PP. Application of mobile health, telemedicine and artificial intelligence to echocardiography. Echo Res Pract. 2019;6:R41–52.

    Article  Google Scholar 

  4. Seetharam K, Shrestha S, Sengupta PP. Artificial intelligence in cardiovascular medicine. Curr Treat Options Cardiovasc Med. 2019;21(6):25.

    Article  Google Scholar 

  5. • Johnson KW, Torres Soto J, Glicksberg BS, Shameer K, Miotto R, Ali M, et al. Artificial intelligence in cardiology. J Am Coll Cardiol. 2018;71(23):2668–79 A comprehensive review regarding the importance and relevance of artificial intelligence in cardiovascular medicine.

    Article  Google Scholar 

  6. Shrestha S, Sengupta PP. Imaging heart failure with artificial intelligence: improving the realism of synthetic wisdom. Circ Cardiovasc Imaging. 2018;11(4):e007723.

    Article  Google Scholar 

  7. Kagiyama N, Shrestha S, Farjo PD, Sengupta PP. Artificial intelligence: practical primer for clinical research in cardiovascular disease. J Am Heart Assoc. 2019;8(17):e012788.

    Article  Google Scholar 

  8. Sengupta PP, Shrestha S. Machine learning for data-driven discovery: the rise and relevance. JACC Cardiovasc Imaging. 2019;12(4):690–2.

    Article  Google Scholar 

  9. Krittanawong C, Zhang H, Wang Z, Aydar M, Kitai T. Artificial intelligence in precision cardiovascular medicine. J Am Coll Cardiol. 2017;69(21):2657–64.

    Article  Google Scholar 

  10. Sengupta PP, Adjeroh DA. Will artificial intelligence replace the human echocardiographer? Circulation. 2018;138(16):1639–42.

    Article  Google Scholar 

  11. Shrestha S, Sengupta PP. Machine learning for nuclear cardiology: The way forward. J Nucl Cardiol. 2019;26(5):1755–8.

  12. Seetharam K, Shresthra S, Mills JD, Sengupta PP. Artificial intelligence in nuclear cardiology: adding value to prognostication. Curr Cardiovasc Imaging Rep. 2019;12(5):14.

    Article  Google Scholar 

  13. • Dey D, Slomka PJ, Leeson P, Comaniciu D, Shrestha S, Sengupta PP, et al. Artificial intelligence in cardiovascular imaging: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(11):1317–35 A comprehensive review article analyzing the relevance of artificial intelligence in cardiovascular imaging. It discusses the potential, pitfalls, and cost of this technology in clinical care.

    Article  Google Scholar 

  14. Bizopoulos P, Koutsouris D. Deep learning in cardiology. IEEE Rev Biomed Eng. 2019;12:168–93.

    Article  Google Scholar 

  15. Al’Aref SJ, Anchouche K, Singh G, Slomka PJ, Kolli KK, Kumar A, et al. Clinical applications of machine learning in cardiovascular disease and its relevance to cardiac imaging. Eur Heart J. 2019;40(24):1975–86.

    Article  Google Scholar 

  16. Mirsky I, Parmley WW. Assessment of passive elastic stiffness for isolated heart muscle and the intact heart. Circ Res. 1973;33(2):233–43.

    Article  CAS  Google Scholar 

  17. Spencer KT, Arling B, Sevenster M, DeCara JM, Lang RM, Ward RP, et al. Identifying errors and inconsistencies in real time while using facilitated echocardiographic reporting. J Am Soc Echocardiogr. 2015;28(1):88–92.e1.

    Article  Google Scholar 

  18. Knackstedt C, Bekkers SCAM, Schummers G, Schreckenberg M, Muraru D, Badano LP, et al. Fully automated versus standard tracking of left ventricular ejection fraction and longitudinal strain: the FAST-EFs multicenter study. J Am Coll Cardiol. 2015;66:1456–66.

    Article  Google Scholar 

  19. Madani A, Arnaout R, Mofrad M, Arnaout R. Fast and accurate view classification of echocardiograms using deep learning. Npj Digit Med. 2018;1(6):1–8.

    Google Scholar 

  20. Narula S, Shameer K, Salem Omar AM, Dudley JT, Sengupta PP. Machine-learning algorithms to automate morphological and functional assessments in 2D echocardiography. J Am Coll Cardiol. 2016;68(21):2287–95.

    Article  Google Scholar 

  21. Sengupta PP, Huang YM, Bansal M, Ashrafi A, Fisher M, Shameer K, et al. Cognitive Machine-Learning Algorithm for Cardiac Imaging: A Pilot Study for Differentiating Constrictive Pericarditis From Restrictive Cardiomyopathy. Circ Cardiovasc Imaging. 2016;9(6):e004330.

  22. Madani A, Arnaout R, Mofrad M, Arnaout R. Fast and accurate view classification of echocardiograms using deep learning. NPJ Digit Med. 2018;1:6.

  23. Madani A, Ong JR, Tibrewal A, Mofrad MRK. Deep echocardiography: data-efficient supervised and semi-supervised deep learning towards automated diagnosis of cardiac disease. NPJ Digit Med. 2018;1:59.

    Article  Google Scholar 

  24. Abdi AH, Luong C, Tsang T, Jue J, Gin K, Yeung D, Hawley D, Rohling R, Abolmaesumi P. Quality assessment of echocardiographic cine using recurrent neural networks: Feasibility on five standard view planes. InInternational Conference on Medical Image Computing and Computer-Assisted Intervention 2017 Sep 10 (pp. 302–310). Springer, Cham.

  25. Gao X, Li W, Loomes M, Wang L. A fused deep learning architecture for viewpoint classification of echocardiography. Inform Fusion. 2017;36:103–13.

    Article  Google Scholar 

  26. •• Knackstedt C, Bekkers SC, Schummers G, Schreckenberg M, Muraru D, Badano LP, et al. Fully automated versus standard tracking of left ventricular ejection fraction and longitudinal strain: the FAST-EFs multicenter study. J Am Coll Cardiol. 2015;66(13):1456–66 One of the earliest multicenter study that utilized AI for automated measurements of the ejection fraction and global longitudinal strain.

    Article  Google Scholar 

  27. Cannesson M, Tanabe M, Suffoletto MS, McNamara DM, Madan S, Lacomis JM, et al. A novel two-dimensional echocardiographic image analysis system using artificial intelligence-learned pattern recognition for rapid automated ejection fraction. J Am Coll Cardiol. 2007;49(2):217–26.

    Article  Google Scholar 

  28. Rahmouni HW, Ky B, Plappert T, Duffy K, Wiegers SE, Ferrari VA, et al. Clinical utility of automated assessment of left ventricular ejection fraction using artificial intelligence-assisted border detection. Am Heart J. 2008;155(3):562–70.

    Article  Google Scholar 

  29. Zoghbi WA, Adams D, Bonow RO, Enriquez-Sarano M, Foster E, Grayburn PA, et al. Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2017;30(4):303–71.

    Article  Google Scholar 

  30. Jeganathan J, Knio Z, Amador Y, Hai T, Khamooshian A, Matyal R, et al. Artificial intelligence in mitral valve analysis. Ann Card Anaesth. 2017;20(2):129–34.

    Article  Google Scholar 

  31. Bianco CM, Farjo PD, Ghaffar YA, Sengupta PP. Myocardial mechanics in patients with normal LVEF and diastolic dysfunction. JACC Cardiovasc Imaging. 2020;13(1 Pt 2):258–71.

    Article  Google Scholar 

  32. •• Casaclang-Verzosa G, Shrestha S, Khalil MJ, Cho JS, Tokodi M, Balla S, et al. Network tomography for understanding phenotypic presentations in aortic stenosis. JACC Cardiovasc Imaging. 2019;12(2):236–48 The landmark paper by Casaclang- Verzosa utilizes topological data analysis to assess the progression of aortic stenosis. The papers shows the evolution of AS is a continuous process, current staging may not be sufficient.

    Article  Google Scholar 

  33. Seetharam K, Kagiyama N, Shrestha S, Sengupta PP. Clinical Inference From Cardiovascular Imaging: Paradigm Shift Towards Machine-Based Intelligent Platform. Current Treatment Options in Cardiovascular Medicine.;22:1–1.

  34. Sanchez-Martinez S, Duchateau N, Erdei T, Kunszt G, Aakhus S, Degiovanni A, et al. Machine learning analysis of left ventricular function to characterize heart failure with preserved ejection fraction. Circ Cardiovasc Imaging. 2018;11(4):e007138.

    Article  Google Scholar 

  35. Lancaster MC, Salem Omar AM, Narula S, Kulkarni H, Narula J, Sengupta PP. Phenotypic clustering of left ventricular diastolic function parameters: patterns and prognostic relevance. JACC Cardiovasc Imaging. 2019;12(7 Pt 1):1149–61.

    Article  Google Scholar 

  36. •• Samad MD, Ulloa A, Wehner GJ, Jing L, Hartzel D, Good CW, et al. Predicting survival from large echocardiography and electronic health record datasets: optimization with machine learning. JACC Cardiovasc Imaging. 2019;12(4):681–9 Samad et al utilizes machine learning in a large sample size by incorporating clinical and echocardiographic components for evaluating clinical outcomes.

    Article  Google Scholar 

  37. Zhang J, Gajjala S, Agrawal P, Tison GH, Hallock LA, Beussink-Nelson L, et al. Fully automated echocardiogram interpretation in clinical practice. Circulation. 2018;138(16):1623–35.

    Article  Google Scholar 

  38. Seetharam K, Shrestha S, Sengupta P. Artificial intelligence in cardiac imaging. US Cardiol Rev. 2020;13:110–6.

    Article  Google Scholar 

  39. Cassar A, Holmes DR Jr, Rihal CS, Gersh BJ. Chronic coronary artery disease: diagnosis and management. Mayo Clin Proc. 2009;84(12):1130–46.

    Article  CAS  Google Scholar 

  40. Tuckson RV, Edmunds M, Hodgkins ML. Telehealth. N Engl J Med. 2017;377(16):1585–92.

    Article  Google Scholar 

  41. Bhavnani SP, Sola S, Adams D, Venkateshvaran A, Dash PK, Sengupta PP. A randomized trial of pocket-echocardiography integrated mobile health device assessments in modern structural heart disease clinics. JACC Cardiovasc Imaging. 2018;11(4):546–57.

    Article  Google Scholar 

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Correspondence to Partho P. Sengupta.

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Conflict of Interest

Karthik Seetharam and Sameer Raina declare that they have no conflict of interest.

Partho P. Sengupta is a consultant for HeartSciences, Ultromics, and Kencor Health.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Echocardiography

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Seetharam, K., Raina, S. & Sengupta, P.P. The Role of Artificial Intelligence in Echocardiography. Curr Cardiol Rep 22, 99 (2020). https://doi.org/10.1007/s11886-020-01329-7

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  • DOI: https://doi.org/10.1007/s11886-020-01329-7

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