American Heart Association

Non-experts with AI guidance and off-site review perform quality mobile rural heart scans

Research Highlights:

  • Health professionals not previously trained in ultrasound were able to perform quality heart scans in a mobile unit that traveled to rural U.S. communities with training and real-time guidance from an artificial intelligence (AI) tool – and reviewed by off-site experts.
  • This approach may help bring heart imaging closer to people living in rural areas and increase their participation in heart disease research.
  • Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4 a.m. CT/5 a.m. ET, Monday, Nov. 2, 2026

This news release contains updated information not available in the abstract.

DALLAS, Nov. 2, 2026 — Artificial intelligence (AI) helped health professionals with no ultrasound experience in capturing quality heart scans in rural communities, which were then reviewed by off-site experts, according to independent, new preliminary research to be presented at the American Heart Association’s Scientific Sessions 2026. The meeting, Nov. 6-9, in Chicago, is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

Echocardiography, or ultrasound scans of the heart, performed with AI assistance and reviewed by experts in other locations, may be one way to bring heart imaging to people living in rural communities. Echocardiography uses ultrasound to give live, moving images of the heart’s structure and function.

According to the American Heart Association, your health care professional may order this test if you have a heart murmur, damaged heart valves, unexplained chest pain, a congenital heart defect, a history of heart attack or stroke, or rheumatic fever.

“Echocardiography is one of the most useful tools we have in cardiovascular research; however, it has historically been very hard to deliver in rural communities,” said study author Sanjana Ravi, M.D., an internal medicine and pediatrics resident at the Duke University School of Medicine in Durham, North Carolina. “The conventional model depends on an expert sonographer working in a hospital setting or imaging center, which can be limited in rural areas. There is also a shortage of cardiovascular imaging specialists in these regions to review and evaluate images, as well as clinicians to share results with patients.”

The current study described how a quality assurance program, including expert review at the Duke Clinical Research Institute Imaging Core Laboratory, supported non-sonographer health care staff in performing AI-guided echocardiography in a mobile examination unit in rural areas. The research is part of the large RURAL (Risk Underlying Rural Areas Longitudinal) study.

What are the study’s main findings?     

  • In heart scans for 4,597 volunteer participants in the RURAL study, 98% of the scans included all six standard echocardiography views required by the study protocol, the current standard practice. Studies were rated adequate (ability to perform measurements on the image) by the core laboratory experts more than 99% of the time. Rates of diagnostic-quality images for individual views ranged from 77% to 94%.
  • Scans were performed within a 15-minute target window 81% of the time, with a median time of 9.5 minutes.
  • Critical results were identified in 133 scans among study volunteers, who were scanned as part of the research study rather than for a medical reason. The most common finding was an ejection fraction of less than 50%, indicating that the heart’s main pumping chamber pushes out a lower-than-normal percentage of its blood with each heartbeat. Of these critical results, 99% were returned to participants within three days.

“We were surprised at how quickly and well the nurses and CT technologists who had never done a heart ultrasound were able to adapt to this technology and produce quality images for review by experts,” Ravi said. “With real-time AI guidance and a rigorous quality-control system behind it, a nurse or CT technologist in a mobile unit can produce heart images good enough for research and good enough to flag serious heart problems that need follow-up, bringing the imaging to the community rather than asking the community to travel to it.”

Lee H. Schwamm, M.D., FAHA, a member of the American Heart Association’s volunteer committee on AI and Technology Innovation, said, “1 in 5 Americans lives in a rural area, which limits their access to critical diagnostic testing and specialty care. In this hybrid model, community-based non-experts were able to create a human-AI partnership with the acquisition software to enable the capture of echocardiogram images that could be read by off-site experts. This novel approach brings heart imaging to local communities and truly meets people where they are. If confirmed in further studies, this approach could serve as a model for other specialties and diagnostic modalities.” Schwamm, who was not involved in this study, is also senior vice president and chief digital health officer of the Yale New Haven Health System and associate dean of digital strategy and transformation at Yale School of Medicine.

Study details, background, design and limitations:

  • Volunteer participants in the RURAL study included 4,597 adults who were ages 25-65 years; average age of 48 years; 67% were women. At enrollment, 63% of participants self-identified as white adults, 35% as Black adults and 2% as Hispanic adults.
  • The larger cohort study included physical exams and tests related to heart, lung and blood vessel health. Fourteen non-sonographers (nurses, nursing assistants and CT technicians) completed the 2-hour training in AI-guided ultrasound; three needed retraining after review of their first scans.
  • Each participant’s exams and testing were conducted in one, 3.5-hour appointment at a mobile health unit that visited 10 rural counties in Alabama, Kentucky, Louisiana and Mississippi between November 2021 and June 2026.
  • All participants received echocardiograms performed by health professionals who were not sonographers. Professionals were trained in a 2-hour, 4-part curriculum that included both virtual and hands-on components in the mobile health unit on how to capture quality heart ultrasound images with real-time guidance from AI-driven software.
  • Images were reviewed by experienced sonographers and physicians with echocardiography certification for completeness and quality, and to measure heart structures. The experts were part of the Duke Clinical Research Institute (DCRI) Imaging Core Laboratory, a specialized team that processes and manages cardiovascular imaging for research studies.
  • The study assessed whether research-quality images could be obtained in a timely manner (with a target time of under 15 minutes).
  • The study has several limitations. There was no direct comparison between sonographer-acquired images and those from AI-guided non-sonographers. The reproducibility of image measurements was also assessed internally and was not validated against other core laboratories. Variability between different operators scanning the same participant was not systematically assessed. Only one brand of software was used, and only one core laboratory was involved, so adapting the strategy to other platforms would require individual testing and validation. The results may not be generalizable to non-rural populations and to AI-guided echocardiograms obtained outside of a core-lab-supported research setting. The study also did not evaluate whether returning participants’ results influenced their care or health.

Co-authors, disclosures and funding sources are listed in the abstract. Gerald S. Bloomfield, M.D., M.P.H., is the study’s principal investigator and is an associate professor of medicine at the Duke University School of Medicine.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

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