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  • Review Article
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Artificial intelligence-enhanced echocardiography in cardiovascular disease management

Nature Reviews Cardiology (2025)Cite this article

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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.

Key points

  • Echocardiography is a crucial tool in cardiology, but is time intensive, produces variable results and requires technical expertise, and current workforce shortages worldwide create delays in patient care.

  • Artificial intelligence (AI) technologies offer transformative solutions for echocardiography, allowing automated image classification, segmentation and measurement.

  • AI methods have shown potential in guiding image acquisition, automating routine echocardiographic measurements such as left ventricular function and detecting cardiovascular diseases such as cardiac amyloidosis, hypertrophic cardiomyopathy and valvular heart disease.

  • Beyond improving workflows and standardization in echocardiography laboratories, potential clinical applications include screening and monitoring for cardiovascular diseases, improving efficacy in clinical trials, task shifting and the expanded use of mobile devices.

  • AI-enhanced echocardiography is advancing rapidly and being integrated into clinical practice at leading centres, but further research is warranted to address its limitations.

  • Developers of AI-enhanced echocardiography should prioritize creating trustworthy applications that support the implementation of user-friendly AI to improve patient care.

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Fig. 1: Overview of AI approaches in echocardiography.
Fig. 2: AI applied at different levels along the echocardiography workflow.
Fig. 3: Potential clinical applications of AI-assisted echocardiography.

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Acknowledgements

We would like to honour the memory of R.M. Lang, an extraordinary leader whose pioneering contributions to echocardiography have left an indelible mark on the field and inspired researchers and clinicians throughout his remarkable career. His passion for education and commitment to advancing medical knowledge will be profoundly missed, but his legacy will continue to inspire future generations of cardiologists and sonographers. We express our sincere gratitude to A. Østvik, L. Løvstakken, E. Smistad and H. Dalen (all from the Norwegian University of Science and Technology, Trondheim, Norway) for their invaluable contributions to the technical aspects related to AI technologies in this article.

Author information

Author notes

  1. These authors contributed equally: Peder L. Myhre, Bjørnar Grenne.

Authors and Affiliations

  1. K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Peder L. Myhre

  2. Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway

    Peder L. Myhre

  3. Department of Cardiology, Akershus University Hospital, Lørenskog, Norway

    Peder L. Myhre

  4. Department of Circulation and Medical Imaging, NTNU: Norwegian University of Science and Technology, Trondheim, Norway

    Bjørnar Grenne

  5. Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway

    Bjørnar Grenne

  6. MedStar Health Research Institute and Georgetown University, Washington, DC, USA

    Federico M. Asch

  7. Heart Institute, University Hospital Germans Trias i Pujol, Badalona, Spain

    Victoria Delgado

  8. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA

    Rohan Khera

  9. Section of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA

    Rohan Khera

  10. Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA

    Rohan Khera

  11. Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA

    Rohan Khera

  12. Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, CT, USA

    Rohan Khera

  13. Bordeaux University, Bordeaux, France

    Stéphane Lafitte

  14. Unité médico-chirurgicale des valvulopathies, CHU Bordeaux, Bordeaux, France

    Stéphane Lafitte

  15. University of Chicago Medical Center, Chicago, IL, USA

    Roberto M. Lang

  16. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

    Patricia A. Pellikka

  17. Division of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Partho P. Sengupta

  18. Division of Cardiology, Duke University School of Medicine, Durham, NC, USA

    Sreekanth Vemulapalli

  19. Duke Clinical Research Institute, Durham, NC, USA

    Sreekanth Vemulapalli

  20. National Heart Centre, Singapore and Duke–National University of Singapore, Singapore, Singapore

    Carolyn S. P. Lam

  21. Baim Institute for Clinical Research, Harvard Medical School, Boston, MA, USA

    Carolyn S. P. Lam

Authors
  1. Peder L. Myhre
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  2. Bjørnar Grenne
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  3. Federico M. Asch
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  4. Victoria Delgado
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  5. Rohan Khera
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  6. Stéphane Lafitte
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  7. Roberto M. Lang
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  8. Patricia A. Pellikka
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  9. Partho P. Sengupta
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  10. Sreekanth Vemulapalli
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Contributions

P.L.M., B.G. and C.S.P.L. researched data for the article. All authors contributed substantially to discussion of content, wrote the article, and reviewed and/or edited the manuscript before submission.

Corresponding author

Correspondence to Carolyn S. P. Lam.

Ethics declarations

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.

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Myhre, P.L., Grenne, B., Asch, F.M. et al. Artificial intelligence-enhanced echocardiography in cardiovascular disease management. Nat Rev Cardiol (2025). https://doi.org/10.1038/s41569-025-01197-0

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