IMR Press / RCM / Volume 23 / Issue 12 / DOI: 10.31083/j.rcm2312402
Open Access Systematic Review
Detecting Left Heart Failure in Echocardiography through Machine Learning: A Systematic Review
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1 Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan Kita Hospital, 15810 Jakarta, Indonesia
2 Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, 10430 Jakarta, Indonesia
3 Department of Computer Science, Faculty of Computer Science Universitas Indonesia, 16424 Depok, Indonesia
4 School of Public Health, Imperial College London, SW7 2BX London, UK
5 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
*Correspondence: dr.liesdina@gmail.com (Lies Dina Liastuti)
Academic Editor: Jerome L. Fleg
Rev. Cardiovasc. Med. 2022, 23(12), 402; https://doi.org/10.31083/j.rcm2312402
Submitted: 26 March 2022 | Revised: 28 September 2022 | Accepted: 30 September 2022 | Published: 12 December 2022
(This article belongs to the Section Cardiovascular Imaging)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Heart failure remains a considerable burden to healthcare in Asia. Early intervention, mainly using echocardiography, to assess cardiac function is crucial. However, due to limited resources and time, the procedure has become more challenging during the COVID-19 pandemic. On the other hand, studies have shown that artificial intelligence (AI) is highly potential in complementing the work of clinicians to diagnose heart failure accurately and rapidly. Methods: We systematically searched Europe PMC, ProQuest, Science Direct, PubMed, and IEEE following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and our inclusion and exclusion criteria. The 14 selected works of literature were then assessed for their quality and risk of bias using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). Results: A total of 2105 studies were retrieved, and 14 were included in the analysis. Five studies posed risks of bias. Nearly all studies included datasets in the form of 3D (three dimensional) or 2D (two dimensional) images, along with apical four-chamber (A4C) and apical two-chamber (A2C) being the most common echocardiography views used. The machine learning algorithm for each study differs, with the convolutional neural network as the most common method used. The accuracy varies from 57% to 99.3%. Conclusions: To conclude, current evidence suggests that the application of AI leads to a better and faster diagnosis of left heart failure through echocardiography. However, the presence of clinicians is still irreplaceable during diagnostic processes and overall clinical care; thus, AI only serves as complementary assistance for clinicians.

Keywords
heart failure
echocardiography
machine learning
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