Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
The Game Changing Impact of Artificial Intelligence
on Heart Failure Diagnosis
1 3
Usha Topalkatti
Internal Medicine, Spartan Health Science University,
School of Medicine, Vieux Fort, Saint Lucia
2 4
Bhagyaraju Koppu
MBBS, MD Paediatric, Sri Rama Chandra University,
Chennai
Abstract:- Recent advancements made in artificial
intelligence (AI) and machine learning (ML) technology
in cardiology and echocardiography has significant
importance to revolutionising diagnosis. AI has potential
to assist in detecting, classifying, diagnosing, and
prognosticating cardiac abnormalities in terms of
improved workflow efficiency, reproducibility, and
diagnostic accuracy. It offers cost-effecti solution to meet
the increasing demand for cardiac imaging. However,
several challenges need to be addressed before AI can be
widely adopted in clinical practice. These challenges
include the need for more data on AI and clinical
outcomes and the validation of AI models through
prospective studies. Overcoming these obstacles through
further research will unlock full potential of AI in
cardiology and echocardiography, ultimately enhancing
medical care.
Keywords:- Artificial Intelligence, Cardiology,
Echocardiography, Diagnostic Accuracy, Heart Failure,
Diagnosis
I. INTRODUCTION
Report by the world health organization (WHO),
cardiovascular disease is responsible for approximately 17.9
million deaths every year [1]. Timely and precise
identification of symptoms can save millions of life [2]. AI
encompasses the digitalization of computer systems to
emulate the cognitive processes exhibited by the human
brain. These intelligent systems adopt a similar
organizational structure to the human brain, wherein neurons
are interconnected in networks known as neural networks
[3]. Researchers from Rutgers institute identified that the
potential of artificial intelligence (AI) and machine learning
in expediting the identification of significant genes
associated with cardiovascular disease [4]. They also
identified that set of genes has notable associations to
cardiovascular disease Moreover, significant variations were
observed in terms of race, gender, and age factors
concerning this disease [4]. With the usage of AI, we can
enhance diagnosis and treatment methods such as
identification of age, environmental factors, genes, race to
IJISRT23JUL436 www.ijisrt.com
Ram Chandra Prasad
MBBS, MD Internal Medicine, Assistant Professor, Mediciti
Institute of Medical Sciences, Hyderabad
Kalva Suchitra Reddy
MBBS, MD General Medicine, SVS Medical college, KNR
University of Health Sciences
improve conditions of patients [6]. The rapid advancement
of AI has notably propelled the development of artificial
neural networks (ANNs), which employ mathematical
models to comprehend complex data [7].This capability
supports patient monitoring, prognosis determination,
diagnosis identification, and disease prevention [8].
Successful implementation of AI in healthcare necessitates
collaborative efforts and stakeholder training. AI has found
numerous applications in the healthcare industry, including
computer-aided fatal evaluation (CAFE) and
cardiotocography (CTG). The System 8000 represents a
technological innovation designed to monitor and track
intermittent variations in fatal movements and heart rate
(FHR) [9]. Despite several benefits, usage of poses
difficulties in upholding data confidentiality, compliance
with legal frameworks, and engaging in ethical
deliberations.
II. REVIEW
 Methodology
We researched online database using PubMed index.
The keywords we use (“role of artificial intelligence in the
diagnosis of heart failure” [Title/Abstract] AND “treatment
of heart disease and role of artificial intelligence”
[Title/Abstract]) OR “artificial intelligence for the diagnosis
of heart failure” [Title/Abstract] AND “heart disease
detection and the use of artificial intelligence” In addition,
we conducted a thorough examination of the reference lists
of papers that were deemed to be potentially relevant in
order to identify supplementary studies. The electronic
searches conducted in this study resulted in the identification
of relevant studies, which were subsequently subjected to
analysis alongside pertinent sources listed in their
bibliographies.
Machine learning is a branch of artificial intelligence
that utilises algorithms to acquire knowledge from data and
generate assessments [10]. It encompasses several categories
of learning based on the feedback received during the
learning process [11]. Supervised learning involves labeled
training data and aims to develop a function mapping input
to output, useful for tasks like regression and classification
210
Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
[12]. Unsupervised learning deals with unlabeled data,
discovering underlying patterns and structures, benefiting
problems without proper labelling [13]. Semi-supervised
learning combines labeled and unlabeled data, often yielding
better results with abundant unlabeled data [14].
Reinforcement learning is a process that entails iterative
experimentation, whereby the algorithm engages with the
environment and is subjected to either rewards or penalties
[15]. Deep learning is a machine learning technique that
employs neural networks with multiple layers to acquire
complex patterns. It has demonstrated remarkable
performance in diverse fields such as speech and image
recognition [16]. It is especially useful for complex data
such as medical images in fields like echocardiography and
computed tomography. Choosing the appropriate learning
category is crucial when designing a machine learning
system, considering the task at hand.
 ECG-Based Machine Learning Approach
Echocardiography plays a crucial role in diagnosing
and managing cardiovascular disease [17]. AI is being
increasingly utilized in medicine to enhance consistency and
reduce variability among different observers. AI
technologies offer promising opportunities for
echocardiography to deliver precise, automated, and more
standardized interpretations [18]. Attia Zl highlights the use
of digital tools to gather valuable information about a
patient's heart health remotely. They found the positive
impact of artificial intelligence in enabling convenient,
affordable, and scalable screening for important medical
conditions [19]. Ulloa-Cerna developed a model through the
analysis of a large dataset covering multiple decades, with
the aim of detecting the occurrence or non-occurrence of
seven echocardiography-confirmed diseases within a one-
year period [20]. The composite model, which incorporates
age, gender, and electrocardiogram (ECG) recordings,
demonstrated a significant area under the receiver operating
characteristic curve and a favourable positive predictive
value. Consequently, it can offer substantial direction for the
suggestion of echocardiography. Simulated retrospective
deployment revealed reliability and significant potential in
identifying high-risk patients and detecting true cases of
echocardiography-confirmed disease [20].
 Early Detection of Heart Failure
Krishnan R found that AI algorithm, qXR-HF, utilizes
chest X-rays to aid in the early detection of heart failure by
analyzing abnormalities and interpreting medical imaging
outputs [20]. By identifying patterns and features indicative
of heart failure, such as an enlarged heart or fluid buildup,
the algorithm provides quick and accurate diagnoses in
under 60 seconds [21]. This technology not only reduces
human error but also improves the chances of successful
treatment and recovery by enabling early detection. The
utilisation of AI in the identification of heart failure through
chest X-rays has the capability to considerably improve
diagnostic precision and efficiency, thereby enabling
healthcare practitioners to deliver optimal healthcare
services to patients [22].
IJISRT23JUL436 www.ijisrt.com
ISSN No:-2456-2165
 Automated Assessment of Myocardial Function and
Valvular Disease
The utilisation of echocardiography is of paramount
importance in the evaluation of left ventricular dimensions
and performance [23]. The manual methodologies employed
in the determination of left ventricular ejection fraction
(LVEF), such as the modified Simpson's biplane approach,
exhibit inconsistency and inadequate association with the
Cardiac MR, which is considered the benchmark [24].
However, the advent of AI technology has introduced
automated measurements in echocardiography, improving
reproducibility, bridging the expertise gap, and enhancing
workflow efficiency in laboratories [25]. Study has
demonstrated the possibility of employing machine learning
algorithms for the automated detection of endocardial
borders, which yields results that are comparable to manual
tracings for 2D ejection fraction, LV volumes, and global
longitudinal strain [26]. The correlation remained robust
with good and moderate image quality but slightly
deteriorated with poor image quality [26]. Additionally,
convolutional neural networks have demonstrated accurate
identification of echocardiographic views and measurement
of specific parameters like LV mass and wall thickness [27].
Evidently, these advancements in AI offer promising
opportunities for precise and efficient analysis in
echocardiography.
 Diastolic Function
There is an increasing incidence of individuals
worldwide who are receiving a diagnosis of heart failure
with preserved ejection fraction, commonly abbreviated as
HFpEF [28]. Accurate analysis of diastolic function using
echocardiography is crucial for diagnosing heart failure, but
it can be challenging due to diverse clinical presentations.
Existing guideline-based algorithms may lead to errors and
indeterminate classifications, hindering diagnosis and
management, especially in the presence of comorbidities.
Furthermore, there exists a lack of uniformity in the
implementation of the prevailing American Society of
Echocardiography (ASE) 2016 diastology criteria, even
amidst seasoned cardiology professionals [29]. Remarkably,
a considerable proportion of patients with HFpEF may be
classified as exhibiting regular diastolic function based on
echocardiographic assessments. AI presents a potential
solution by assisting in detecting diastolic dysfunction in
patients deemed normal by current criteria or by facilitating
consistent interpretation of diastolic parameters based on
guideline criteria.
Pandey et al. employed Machine Learning (ML)
techniques to construct a model aimed at evaluating patients
exhibiting elevated filling pressures [30]. The model was
then compared to the ASE 2016 diastolic guidelines grading
system. The machine learning model exhibited superior
performance compared to the ASE guidelines, as evidenced
by a higher receiver-operating characteristic (ROC) value
(0.88 vs. 0.67; p = 0.01) in its ability to predict elevated left
ventricular filling pressures [30]. The model also identified a
higher-risk phenotype group, which exhibited a greater
likelihood of hospitalization and a better response to
211
Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
spironolactone therapy [30]. Echocardiographic evaluation
of diastolic function in HFpEF can be challenging, leading
to errors and inconsistent classifications. AI, through
machine learning models, offers the potential to improve the
detection of diastolic dysfunction and provide more
consistent interpretations, aiding in the diagnosis and
management of HFpEF patients.
 Global Longitudinal Strain
The deformation resulting from myocardial
contraction, commonly known as Global Longitudinal Strain
(GLS), is a significant parameter in the study of myocardial
mechanics using speckle tracking [31]. The clinical utility of
GLS lies in its ability to detect subclinical ventricular
dysfunction that may not be discernible through standard
two-dimensional echocardiography [32]. The utilisation of
this diagnostic tool is prevalent in the identification of
chemotherapy-induced cardiotoxicity [32]. Additionally, it
serves as a valuable diagnostic measure for a range of
cardiac ailments, including but not limited to cardiac
amyloidosis, hypertrophic cardiomyopathy, myocardial
infarction, and constriction. The assessment of GLS has
garnered increasing attention in the medical research
community, with a particular focus on the utilisation of
machine learning techniques [33]. Satle devised a machine
learning algorithm to assess GLS in a cohort of 200
individuals through the utilisation of conventional
echocardiographic views. They subsequently compared the
performance of their model against that of the standard
speckle-tracking software, EchoPac GE [34]. The automated
model effectively identified standard apical views, timed
cardiac events, and measured GLS across a range of cardiac
conditions. The research findings indicate negligible
disparities between the two modalities, with an average
absolute deviation of merely 1.8%. Of significant note, the
employment of an AI-based methodology exhibited a
noteworthy reduction in time consumption, necessitating
less than 15 seconds per study as opposed to the 5-10
minutes required by the traditional technique [35]. Machine
learning techniques can effectively assess GLS by
automatically identifying views and measuring strain,
offering comparable results to standard speckle-tracking
software. Not only does this approach save time, but it also
holds promise for streamlining the evaluation of GLS and
enhancing clinical decision-making.
 The Role of AI in Identifying Disease States
The utilization of AI in echocardiography to detect
disease states is driven by its ability to automatically analyze
image and data features that may go unnoticed by humans.
During routine echocardiography, a vast amount of
potentially diagnostically relevant information may remain
underutilized due to the challenge of interpreting the entirety
of the data within a limited time frame [36]. AI has the
potential to uncover the hidden value in these findings and
can analyze the information at a faster pace compared to
human experts. The employment of AI in echocardiography
is experiencing swift growth in its clinical applications. This
includes the detection of particular disease states and
processes such as valvular heart diseases, coronary artery
IJISRT23JUL436 www.ijisrt.com
ISSN No:-2456-2165
disease, hypertrophic cardiomyopathy, cardiac amyloidosis,
cardiomyopathies, and cardiac masses.
Within the realm of valvular heart diseases, AI has
demonstrated potential in the quantification of disease
severity through echocardiography, as well as in the
identification of populations at high risk for these conditions
[37]. Novel image recognition algorithms have been devised
to enable direct detection of valve disorders from
unprocessed echocardiographic images [38]. Amalgamation
of these images with clinical data has facilitated the
discovery of fresh prognostic factors for the advancement of
the disease. Accurate algorithms have been created to assess
the severity of mitral and aortic valve diseases, detect the
presence of prosthetic valves, and identify rheumatic heart
disease [38]. Advancements in this area have the potential to
revolutionize the evaluation and management of patients
with valve diseases by simulating or replacing the currently
required multimodal assessment.
 Valvular Heart Disease
In a recent clinical investigation encompassing a cohort
of approximately 2,000 individuals diagnosed with aortic
stenosis, AI was employed to amalgamate
echocardiographic metrics and enhance the stratification of
disease severity, along with the identification of
subpopulations at elevated risk [39]. The utilisation of
various parameters such as aortic valve calcium scores, late
gadolinium enhancement, biomarker levels, and negative
clinical outcomes can aid in the identification of individuals
who are at a higher risk. This information can be used to
optimise the timing of aortic valve replacements [40]. A
novel investigation has established a theoretical structure for
the automated assessment of echocardiographic recordings
to detect mitral and aortic valve pathologies, employing
sophisticated machine learning algorithms [41]. The present
framework has effectively classified echocardiographic
views, identified the existence of valve heart disease, and
precisely measured the severity of the disease. The findings
corroborated the efficacy of an automated system that was
trained on regular echocardiographic datasets to screen,
categorise, and measure the severity of frequently occurring
medical conditions [41]. These advancements demonstrate
the potential of AI in improving the assessment and
management of valvular heart diseases through more
accurate and efficient analysis of echocardiographic data.
 Advancements in AI for Coronary Artery Disease
 Automated Analysis of Stress Echocardiograms:
In a recent clinical investigation comprising of
approximately 2,000 individuals diagnosed with aortic
stenosis, AI was utilised [39]. A novel automated image
processing pipeline has been devised for the purpose of
extracting geometric and kinematic features from stress
echocardiograms. The results of our study indicate that the
implemented machine learning model demonstrated a
notable level of accuracy in the classification of patients
with severe coronary artery disease [42]. The utilisation of
AI in the analysis of stress echocardiograms has
212
Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
demonstrated enhanced precision, consistency between
readers, and reader assurance. This development has
effectively tackled the issue of subjective recognition of
regional wall motion abnormalities.
 Differentiation of Acute Coronary Syndrome-Like
Diseases:
The utilisation of artificial intelligence exhibits
promising prospects in distinguishing medical conditions
that manifest with clinical features akin to acute coronary
syndrome [43]. A system was developed for real-time
interpretation of echocardiogram videos to differentiate
between TakoTsubo syndrome and acute myocardial
infarction [44]. The findings of the study indicate that the
model exhibits superior accuracy in disease classification
compared to expert cardiologists. However, additional
research is required before the model can be implemented in
a clinical setting [44].
 Prediction of Left Ventricular Recovery:
AI models offer the potential to predict left ventricular
recovery after coronary syndromes. A study used texture
parameters of echocardiograms to evaluate left ventricular
function recovery one year after myocardial infarction [45].
Preliminary results were promising, indicating a prediction
error lower than 30%, but further research is needed for
clinical application. These advancements in AI provide
valuable tools for the effective management of patients with
coronary artery disease, offering automated classifications,
improved accuracy, and potential predictions for recovery.
 Etiology Differentiation of Increased Left Ventricular
Wall Thickness
 Echocardiography-AI-Based Myocardial Texture
Analysis:
The utilisation of echocardiography for myocardial
texture analysis based on artificial intelligence has been
implemented to distinguish between hypertrophic
cardiomyopathy, hypertensive heart disease, and uremic
cardiomyopathy [46]. This approach utilizes myocardial
texture features and has shown promising results in
differentiating the etiologies of left ventricular hypertrophy.
 Machine Learning Framework for Discrimination of
Physiological vs. Pathological Hypertrophy:
A machine learning framework incorporating
echocardiographic data has been developed to discriminate
hypertrophic cardiomyopathy from physiological
hypertrophy seen in athletes. This AI model demonstrates
improved sensitivity and specificity compared to
conventional parameters, aiding in the differentiation of
physiological and pathological patterns of hypertrophic
remodelling [47].
 AI Models for Cardiac Amyloidosis Diagnosis:
AI models have been applied to diagnose cardiac
amyloidosis using echocardiography. A video-based
echocardiography model achieved high performance in
distinguishing cardiac amyloidosis from other conditions
IJISRT23JUL436 www.ijisrt.com
ISSN No:-2456-2165
[48]. A novel workflow guided by artificial intelligence has
been developed to precisely quantify the thickness of the left
ventricle wall and predict the underlying cause of
hypertrophy, which could be either hypertrophic
cardiomyopathy or cardiac amyloidosis [49]. These AI
models offer efficient and accurate evaluation of patients
with cardiac amyloidosis.
 Deep Learning Algorithm for Etiology Diagnosis of Left
Ventricular Hypertrophy:
A deep learning model was devised to distinguish
between prevalent aetiologies of left ventricular
hypertrophy, such as hypertensive heart disease,
hypertrophic cardiomyopathy, and AL-cardiac amyloidosis.
Using standard echocardiographic views, the AI model
demonstrated high diagnostic accuracy, surpassing that of
echocardiography specialists [50]. This highlights the
potential of AI in improving the diagnostic process for
patients with left ventricular hypertrophy.
 Cardiomyopathies
The potential of AI-supported diagnosis of
cardiomyopathies is significant in enhancing diagnostic
accuracy, particularly during the initial phases when
identifying structural echocardiographic indications may be
challenging for human observation [50]. AI algorithms can
aid in ventricular segmentation, volume measurement, and
assessment of myocardial function and motion. Previous
studies have explored the automatic detection of dilated
cardiomyopathy using machine learning frameworks. While
classification accuracy showed promise, further research is
needed before considering clinical application [51]. Deep
learning algorithms have been developed to differentiate
specific cardiomyopathies based on echocardiography
videos. AI-assisted diagnosis has been used to distinguish
cardiac sarcoidosis and to differentiate between constrictive
pericarditis and restrictive cardiomyopathy. These AI
models have shown comparable diagnostic accuracy to
human experts and have the potential to enhance disease
classification [52]. Our recent research has demonstrated the
successful differentiation of four prevalent cardiovascular
diseases from normal subjects through the use of
echocardiographic videos obtained during standard clinical
care [53]. This was achieved through the implementation of
an end-to-end deep learning framework. The algorithmic
model successfully detected pertinent anatomical regions of
interest for every diagnosis and exhibited a level of accuracy
that is comparable to a collective agreement among
experienced cardiologists [53]. These findings highlight the
potential of AI-assisted echocardiography in enhancing the
accuracy of cardiomyopathy diagnostic classification, even
across different ultrasound equipment from various
manufacturers [54].
 Intracardiac masses
Intracardiac masses pose a challenge for accurate
echocardiographic diagnosis, as differentiating between
thrombosis, tumors, or vegetation is crucial for determining
appropriate treatment options. Advanced imaging techniques
like MRI are often required for further characterization. AI
213
Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
technology offers potential solutions for classifying and
recognizing intracardiac masses. Previous research has
demonstrated the use of texture analysis in echocardiograms
to classify and segment intracardiac masses, reflecting
certain physiological properties of heart tissues [55].
A recent investigation was conducted to examine the
efficacy of a computer-aided diagnostic algorithm in
detecting left atrial thrombi in patients with atrial fibrillation
through transesophageal echocardiography [56].The
algorithm generated by artificial intelligence demonstrated a
notable enhancement in diagnostic precision for left atrial
thrombi in contrast to the conventional methodology
employed by specialists. These findings highlight the
potential of AI-assisted diagnosis in enhancing the
identification and characterization of intracardiac masses,
providing valuable support in clinical decision-making [56].
III. LIMITATIONS
Although AI presents notable benefits in the fields of
cardiology and medicine, it is not exempt from constraints.
A significant issue of concern pertains to the absence of
interpretability in artificial intelligence models that are
commonly referred to as "black boxes". The algorithmic
generation of models from raw data poses a challenge for
human comprehension, including that of the designers, with
regards to the amalgamation of variables for predictive
purposes. This lack of interpretability can hinder the clinical
interpretation and verification of AI model results. Most
studies on AI applications in cardiology have been
retrospective, and the validation of AI algorithms in large
multicenter studies is still needed. Additionally, some
machine learning models rely on labeled data, assuming that
the provided labels are perfect truths [57]. However, this
approach may introduce bias during the labeling process,
affecting the accuracy and generalizability of the AI models.
Ensuring the quality of input data is crucial for developing
robust AI models.
The implementation of artificial intelligence in the
medical field presents a number of legal and ethical
considerations. The utilisation of AI applications frequently
necessitates the acquisition of extensive databases and
registries that contain confidential patient data to facilitate
the training of the models [58]. This raises concerns about
data security and the potential for large-scale data breaches,
compromising patient privacy. Such security breaches can
lead to a loss of patient trust and limit participation in future
prospective trials.
From a technical perspective, AI applications in
echocardiography face challenges. Variations in vendor-
dependent setups and difficulties in obtaining optimal image
quality or accurate views can impact the accuracy of AI
models. Preprocessing of nonstructural or suboptimal
echocardiographic data may be necessary, adding
complexity to the implementation of AI in clinical practice.
Addressing these limitations and concerns is crucial to
ensure the responsible and effective use of AI in cardiology,
IJISRT23JUL436 www.ijisrt.com
ISSN No:-2456-2165
promoting transparency, data quality, privacy protection,
and technical advancements to maximize the potential
benefits of this technology in healthcare.
IV. CONCLUSION
The progress of AI applications in the fields of
cardiology and echocardiography is rapidly evolving and
holds the promise of revolutionising the delivery of medical
attention to patients. The implementation of these algorithms
has the potential to aid in the identification, categorization,
diagnosis, and prognostication of cardiac irregularities,
resulting in enhanced operational efficacy, replicability, and
diagnostic precision. Additionally, they present a cost-
efficient approach to addressing the growing need for
cardiac imaging management. Notwithstanding, there exist
certain obstacles that need to be addressed, including
insufficient information pertaining to the impact of artificial
intelligence on clinical results. Further research, particularly
prospective studies, is necessary to evaluate the accuracy,
effectiveness, and impact of AI on patient outcomes. By
addressing these obstacles, AI has the potential to
revolutionize cardiology and echocardiography practice.
REFERENCES
[1]. World Health Organization. (2022). Cardiovascular
Diseases. World Health Organization.
https://www.who.int/health-topics/cardiovascular-
diseases#tab=tab_1
[2]. Allen, C. J. (2020, December 10). How to Improve
Time to Diagnosis in Acute Heart Failure – Clinical
Signs and Chest X-ray. Radcliffe Cardiology; Radcliffe
Cardiology.
https://doi.org/10.15420%2Fcfr.2015.1.2.69
[3]. Iftikhar P, Kuijpers MV, Khayyat A, Iftikhar A,
DeGouvia De Sa M: Artificial intelligence: a new
paradigm in obstetrics and gynecology research and
clinical practice. Cureus. 2020, 12:e7124.
10.7759/cureus.7124
[4]. Rutgers Researchers Use Artificial Intelligence To
Predict Cardiovascular Disease. (2023, February 28).
Targeted News Service, NA.
https://link.gale.com/apps/doc/A738940973/HRCA?u=
anon~c7c6bc9c&sid=sitemap&xid=b142e64f
[5]. Murdock D.R., Venner E., Muzsny D.M., Metcalf
G.A., Murugan M., Hadley T.D., Chander V., de Vries
P.S., Jia X., Hussain A., et al. Genetic testing in
ambulatory cardiology clinics reveals high rate of
findings with clinical management implications. Genet.
Med. 2021;23:2404–2414. doi: 10.1038/s41436-021-
01294-8.
[6]. Desai GS: Artificial intelligence: the future of
obstetrics and gynecology. J Obstet Gynaecol India.
2018, 68:326-7. 10.1007/s13224-018-1118-4
[7]. Beam AL, Kohane IS: Big data and machine learning
in health care. JAMA. 2018, 319:1317-8.
10.1001/jama.2017.18391
[8]. Dawes, G. S., Moulden, M., & Redman, C. W. (1991).
System 8000: computerized antenatal FHR analysis.
214
Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
Journal of perinatal medicine, 19(1-2), 47–51.
https://doi.org/10.1515/jpme.1991.19.1-2.47
[9]. Jordan MI, Mitchell TM. Machine learning: Trends,
perspectives, and prospects. Science.
2015;349(6245):255-260. doi:10.1126/science.aaa8415
[10]. Sidey-Gibbons JAM, Sidey-Gibbons CJ. Machine
learning in medicine: a practical introduction. BMC
Med Res Methodol. 2019;19(1):64. Published 2019
Mar 19. doi:10.1186/s12874-019-0681-4
[11]. Sidey-Gibbons JAM, Sidey-Gibbons CJ. Machine
learning in medicine: a practical introduction. BMC
Med Res Methodol. 2019;19(1):64. Published 2019
Mar 19. doi:10.1186/s12874-019-0681-4
[12]. Khan MM, Siddique MdA, Arif RB, Oishe MR.
ADBSCAN: Adaptive density-based spatial clustering
of applications with noise for identifying clusters with
varying densities. 2018 4th International Conference
on Electrical Engineering and Information &
Communication Technology (iCEEiCT). Published
online 2018:107-111.
doi:10.1109/ceeict.2018.8628138
[13]. Wongchaisuwat P, Klabjan D, Jonnalagadda SR. A
Semi-Supervised Learning Approach to Enhance
Health Care Community-Based Question Answering:
A Case Study in Alcoholism. JMIR Med Inform.
2016;4(3):e24. Published 2016 Aug 2.
doi:10.2196/medinform.5490
[14]. van Otterlo M., Wiering M., editors. Reinforcement
Learning: State-of-the-Art. Springer;
Berlin/Heidelberg, Germany: 2012. Reinforcement
Learning and Markov Decision Processes; pp. 3–42.
[15]. Goodfellow I. Deep Learning. MIT Press; Cambridge,
MA, USA: 2016
[16]. OH J. Echocardiography in heart failure: Beyond
diagnosis. European Journal of Echocardiography.
2007;8(1):4-14. doi:10.1016/j.euje.2006.09.002
[17]. OH J. Echocardiography in heart failure: Beyond
diagnosis. European Journal of Echocardiography.
2007;8(1):4-14. doi:10.1016/j.euje.2006.09.002
[18]. Attia ZI, Noseworthy PA, Lopez-Jimenez F, et al. An
artificial intelligence-enabled ECG algorithm for the
identification of patients with atrial fibrillation during
sinus rhythm: a retrospective analysis of outcome
prediction. Lancet. 2019;394(10201):861-867.
doi:10.1016/S0140-6736(19)31721-0
[19]. Ulloa-Cerna AE, Jing L, Pfeifer JM, et al.
rECHOmmend: An ECG-Based Machine Learning
Approach for Identifying Patients at Increased Risk of
Undiagnosed Structural Heart Disease Detectable by
Echocardiography. Circulation. 2022;146(1):36-47.
doi:10.1161/CIRCULATIONAHA.121.057869
[20]. Krishnan R, Arora C, Pordon C. The role of AI in heart
failure early detection: Qure Ai. Qure AI | AI to enable
accessible, affordable & timely care across the
globe. February 12, 2023. Accessed June 19, 2023.
https://qure.ai/the-role-of-ai-in-heart-failure-early-
detection/.
[21]. Liong-Rung L, Hung-Wen C, Ming-Yuan H, et al.
Using Artificial Intelligence to Establish Chest X-Ray
Image Recognition Model to Assist Crucial Diagnosis
IJISRT23JUL436 www.ijisrt.com
ISSN No:-2456-2165
in Elder Patients With Dyspnea. Front Med
(Lausanne). 2022;9:893208. Published 2022 Jun 3.
doi:10.3389/fmed.2022.893208
[22]. Kumar Y, Koul A, Singla R, Ijaz MF. Artificial
intelligence in disease diagnosis: a systematic literature
review, synthesizing framework and future research
agenda. J Ambient Intell Humaniz Comput.
2023;14(7):8459-8486. doi:10.1007/s12652-021-
03612-z
[23]. Nicol P, Rank A, Lenz T, et al. Echocardiographic
evaluation of left ventricular function using an
automated analysis algorithm is feasible for beginners
and experts: comparison with invasive and non-
invasive methods. J Echocardiogr. 2023;21(2):65-73.
doi:10.1007/s12574-022-00590-9
[24]. Franchi F, Cameli M, Taccone FS, et al. Assessment of
left ventricular ejection fraction in critically ill patients
at the time of speckle tracking echocardiography:
intensivists in training for echocardiography versus
experienced operators. Minerva Anestesiol.
2018;84(11):1270-1278. doi:10.23736/S0375-
9393.18.12249-8
[25]. Barry T, Farina JM, Chao C-J, Ayoub C, Jeong J, Patel
BN, Banerjee I, Arsanjani R. The Role of Artificial
Intelligence in Echocardiography. Journal of Imaging.
2023; 9(2):50.
https://doi.org/10.3390/jimaging9020050
[26]. Asch FM, Poilvert N, Abraham T, et al. Automated
Echocardiographic Quantification of Left Ventricular
Ejection Fraction Without Volume Measurements
Using a Machine Learning Algorithm Mimicking a
Human Expert. Circulation: Cardiovascular Imaging.
2019;12(9).
doi:https://doi.org/10.1161/circimaging.119.009303
[27]. Barry T, Farina JM, Chao CJ, et al. The Role of
Artificial Intelligence in Echocardiography. J Imaging.
2023;9(2):50. Published 2023 Feb 20.
doi:10.3390/jimaging9020050
[28]. Upadhya B, Kitzman DW. Heart failure with preserved
ejection fraction: New approaches to diagnosis and
management. Clin Cardiol. 2020;43(2):145-155.
doi:10.1002/clc.23321
[29]. van de Bovenkamp AA, Enait V, de Man FS, et al.
Validation of the 2016 ASE/EACVI Guideline for
Diastolic Dysfunction in Patients With Unexplained
Dyspnea and a Preserved Left Ventricular Ejection
Fraction. J Am Heart Assoc. 2021;10(18):e021165.
doi:10.1161/JAHA.121.021165
[30]. Pandey A, Kagiyama N, Yanamala N, et al. Deep-
Learning Models for the Echocardiographic
Assessment of Diastolic Dysfunction. JACC:
Cardiovascular Imaging. 2021;14(10):1887-1900.
doi:https://doi.org/10.1016/j.jcmg.2021.04.010
[31]. Smiseth OA, Torp H, Opdahl A, Haugaa KH, Urheim
S. Myocardial strain imaging: how useful is it in
clinical decision making?. Eur Heart J.
2016;37(15):1196-1207. doi:10.1093/eurheartj/ehv529
[32]. Krishnasamy R, Isbel NM, Hawley CM, et al. Left
Ventricular Global Longitudinal Strain (GLS) Is a
Superior Predictor of All-Cause and Cardiovascular
215
Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
Mortality When Compared to Ejection Fraction in
Advanced Chronic Kidney Disease. PLoS One.
2015;10(5):e0127044. Published 2015 May 15.
doi:10.1371/journal.pone.0127044
[33]. Wang F, Deng Y, Li S, et al. CMR left ventricular
strains beyond global longitudinal strain in
differentiating light-chain cardiac amyloidosis from
hypertrophic cardiomyopathy. Front Cardiovasc Med.
2023;10:1108408. Published 2023 May 3.
doi:10.3389/fcvm.2023.1108408
[34]. Alsharqi M, Woodward WJ, Mumith JA, Markham
DC, Upton R, Leeson P. Artificial intelligence and
echocardiography. Echo Res Pract. 2018;5(4):R115-
R125. doi:10.1530/ERP-18-0056
[35]. Salte IM, Østvik A, Smistad E, et al. Artificial
Intelligence for Automatic Measurement of Left
Ventricular Strain in Echocardiography. JACC
Cardiovasc Imaging. 2021;14(10):1918-1928.
doi:10.1016/j.jcmg.2021.04.018
[36]. Alsharqi M, Woodward WJ, Mumith JA, Markham
DC, Upton R, Leeson P. Artificial intelligence and
echocardiography. Echo Res Pract. 2018;5(4):R115-
R125. doi:10.1530/ERP-18-0056
[37]. Nedadur R, Wang B, Tsang W. Artificial intelligence
for the echocardiographic assessment of valvular heart
disease. Heart. 2022;108(20):1592-1599. Published
2022 Sep 26. doi:10.1136/heartjnl-2021-319725
[38]. Maganti K, Rigolin VH, Sarano ME, Bonow RO.
Valvular heart disease: diagnosis and management.
Mayo Clin Proc. 2010;85(5):483-500.
doi:10.4065/mcp.2009.0706
[39]. Sengupta PP, Shrestha S, Kagiyama N, et al. A
Machine-Learning Framework to Identify Distinct
Phenotypes of Aortic Stenosis Severity. JACC
Cardiovasc Imaging. 2021;14(9):1707-1720.
doi:10.1016/j.jcmg.2021.03.020
[40]. Sengupta PP, Shrestha S, Kagiyama N, et al. A
Machine-Learning Framework to Identify Distinct
Phenotypes of Aortic Stenosis Severity. JACC
Cardiovasc Imaging. 2021;14(9):1707-1720.
doi:10.1016/j.jcmg.2021.03.020
[41]. Yang F, Chen X, Lin X, et al. Automated Analysis of
Doppler Echocardiographic Videos as a Screening
Tool for Valvular Heart Diseases. JACC Cardiovasc
Imaging. 2022;15(4):551-563.
doi:10.1016/j.jcmg.2021.08.015
[42]. Upton R, Mumith A, Beqiri A, et al. Automated
Echocardiographic Detection of Severe Coronary
Artery Disease Using Artificial Intelligence. JACC
Cardiovasc Imaging. 2022;15(5):715-727.
doi:10.1016/j.jcmg.2021.10.013
[43]. Saraste A, Barbato E, Capodanno D, et al. Imaging in
ESC clinical guidelines: chronic coronary syndromes.
Eur Heart J Cardiovasc Imaging. 2019;20(11):1187-
1197. doi:10.1093/ehjci/jez219
[44]. Laumer F, Di Vece D, Cammann VL, et al.
Assessment of Artificial Intelligence in
Echocardiography Diagnostics in Differentiating
Takotsubo Syndrome From Myocardial Infarction.
IJISRT23JUL436 www.ijisrt.com
ISSN No:-2456-2165
JAMA Cardiol. 2022;7(5):494-503.
doi:10.1001/jamacardio.2022.0183
[45]. Zhou J, Du M, Chang S, Chen Z. Artificial intelligence
in echocardiography: detection, functional evaluation,
and disease diagnosis. Cardiovasc Ultrasound.
2021;19(1):29. Published 2021 Aug 20.
doi:10.1186/s12947-021-00261-2
[46]. Yu F, Huang H, Yu Q, Ma Y, Zhang Q, Zhang B.
Artificial intelligence-based myocardial texture
analysis in etiological differentiation of left ventricular
hypertrophy. Ann Transl Med. 2021;9(2):108.
doi:10.21037/atm-20-4891
[47]. Yu F, Huang H, Yu Q, Ma Y, Zhang Q, Zhang B.
Artificial intelligence-based myocardial texture
analysis in etiological differentiation of left ventricular
hypertrophy. Ann Transl Med. 2021;9(2):108.
doi:10.21037/atm-20-4891
[48]. Goto S, Mahara K, Beussink-Nelson L, et al. Artificial
intelligence-enabled fully automated detection of
cardiac amyloidosis using electrocardiograms and
echocardiograms. Nat Commun. 2021;12(1):2726.
Published 2021 May 11. doi:10.1038/s41467-021-
22877-8
[49]. Duffy G, Cheng PP, Yuan N, et al. High-Throughput
Precision Phenotyping of Left Ventricular Hypertrophy
With Cardiovascular Deep Learning. JAMA Cardiol.
2022;7(4):386-395. doi:10.1001/jamacardio.2021.6059
[50]. Susumu Katsushika, Satoshi Kodera, Nakamoto M, et
al. Deep Learning Algorithm to Detect Cardiac
Sarcoidosis From Echocardiographic Movies.
2021;86(1):87-95. doi:https://doi.org/10.1253/circj.cj-
21-0265
[51]. Mahmood R, Syeda-Mahmood T. Automatic detection
of dilated cardiomyopathy in cardiac ultrasound
videos. AMIA Annu Symp Proc. 2014;2014:865-871.
Published 2014 Nov 14.
[52]. Katsushika S, Kodera S, Nakamoto M, et al. Deep
Learning Algorithm to Detect Cardiac Sarcoidosis
From Echocardiographic Movies. Circ J.
2021;86(1):87-95. doi:10.1253/circj.CJ-21-0265
[53]. Sengupta PP, Huang YM, Bansal M, 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.
doi:10.1161/CIRCIMAGING.115.004330
[54]. Liu B, Chang H, Yang D, et al. A deep learning
framework assisted echocardiography with diagnosis,
lesion localization, phenogrouping heterogeneous
disease, and anomaly detection. Sci Rep. 2023;13(1):3.
Published 2023 Jan 2. doi:10.1038/s41598-022-27211-
w
[55]. Strzelecki M, Materka A, Drozdz J, Krzeminska-
Pakula M, Kasprzak JD. Classification and
segmentation of intracardiac masses in cardiac tumor
echocardiograms. Comput Med Imaging Graph.
2006;30(2):95-107.
doi:10.1016/j.compmedimag.2005.11.004
216
Volume 8, Issue 7, July – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
[56]. Sun L, Li Y, Zhang YT, et al. A computer-aided
diagnostic algorithm improves the accuracy of
transesophageal echocardiography for left atrial
thrombi: a single-center prospective study. J
Ultrasound Med. 2014;33(1):83-91.
doi:10.7863/ultra.33.1.83
[57]. Dell'Angela L, Nicolosi GL. Artificial intelligence
applied to cardiovascular imaging, a critical focus on
echocardiography: The point-of-view from "the other
side of the coin". J Clin Ultrasound. 2022;50(6):772-
780. doi:10.1002/jcu.23215
[58]. Buzaev IV, Plechev VV, Nikolaeva IE, Galimova RM.
Artificial intelligence: Neural network model as the
multidisciplinary team member in clinical decision
support to avoid medical mistakes. Chronic Dis Transl
Med. 2016;2(3):166-172. Published 2016 Nov 22.
doi:10.1016/j.cdtm.2016.09.007

IJISRT23JUL436 www.ijisrt.com 217