Implementing focused echocardiography and AI-supported analysis in a population-based survey in Lesotho: implications for community-based cardiovascular disease care models

Hypertens Res. 2024 Mar;47(3):708-713. doi: 10.1038/s41440-023-01559-6. Epub 2024 Jan 16.

Abstract

In settings where access to expert echocardiography is limited, focused echocardiography, combined with artificial intelligence (AI)-supported analysis, may improve diagnosis and monitoring of left ventricular hypertrophy (LVH). Sixteen nurses/nurse-assistants without prior experience in echocardiography underwent a 2-day hands-on intensive training to learn how to assess parasternal long axis views (PLAX) using an inexpensive hand-held ultrasound device in Lesotho, Southern Africa. Loops were stored on a cloud-drive, analyzed using deep learning algorithms at the University Hospital Basel, and afterwards confirmed by a board-certified cardiologist. The nurses/nurse-assistants obtained 756 echocardiograms. Of the 754 uploaded image files, 628 (83.3%) were evaluable by deep learning algorithms. Of those, results of 514/628 (81.9%) were confirmed by a cardiologist. Of the 126 not evaluable by the AI algorithm, 46 (36.5%) were manually evaluable. Overall, 660 (87.5%) uploaded files were evaluable and confirmed. Following short-term training of nursing cadres, a high proportion of obtained PLAX was evaluable using AI-supported analysis. This could be a basis for AI- and telemedical support in hard-to-reach areas with minimal resources.

Keywords: AI-supported analysis; Community-based care; Focused echocardiography; Left ventricular hypertrophy; Lesotho.

MeSH terms

  • Artificial Intelligence
  • Benzoates*
  • Cardiovascular Diseases* / diagnostic imaging
  • Echocardiography / methods
  • Humans
  • Lesotho
  • Sodium Dodecyl Sulfate*

Substances

  • Plax
  • Benzoates
  • Sodium Dodecyl Sulfate