ArticleNPJ digital medicine2026
Improving structural heart disease screening: AI-ECG and novice AI-guided focused cardiac ultrasound.
Article in NPJ digital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Structural heart disease (SHD) causes substantial morbidity, yet early detection is limited. In this prospective study, AI-enhanced ECG and AI-guided focused cardiac ultrasound (AI-FoCUS) were assessed for detecting SHD (left ventricular EF < 40%, ≥moderate aortic stenosis, hypertrophic cardiomyopathy, or cardiac amyloidosis) in 995 adults against comprehensive echocardiography performed within 30 min of AI-FoCUS. Nine complete novices used handheld ultrasound (Philips Lumify) with real-time AI guidance (UltraSight) with images interpreted by blinded experts. AI-FoCUS was feasible in 97.3%. Prevalence was 5.0% for EF < 40%, 3.5% for ≥moderate aortic stenosis, and 8.8% for hypertrophic cardiomyopathy or amyloidosis. AI-ECG alone yielded NPV 95.8% but PPV 29.6%, limiting standalone screening. AI-FoCUS alone achieved PPV 95.4% and NPV 98.0%, however requires imaging in all. A two-step strategy (positive AI-ECG followed by AI-FoCUS) maintained high PPV/NPV (96.1%/95.6%) but limited FoCUS imaging to 47%.In this echo referral cohort, novice AI-guided FoCUS acquisition with blinded expert interpretation was feasible and accurate for detecting selected SHD phenotypes. A two-step AI-ECG then AI-FoCUS strategy reduced FoCUS utilization, but lowered sensitivity compared with AI-FoCUS for all. However, both FoCUS-based strategies were superior to AI-ECG based screening alone. This work requires further assessment and validation in lower prevalence populations.
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