Dr. Fawaz Alenezi, MD on the results of his study at ASE 2025.

While improvements in echocardiography hardware historically drive innovation, echo software might be where the real breakthroughs lie. Watch this episode of the Cardiac Wire Show to learn from Duke’s Dr. Fawaz Alenezi, MD about Us2.ai’s potential for HCM detection.

Cardiology

Cardiac Wire’s ASE 2025 Takeaways

The American Society of Echocardiography left an echo this year in Music City as it celebrated its 50th year. Among the studies and products unveiled at ASE 2025, here are Cardiac Wire’s top five takeaways from the meeting.

Premium Echo Has Found its Stride – Although most typically think of ultrasound as a lower cost modality, the number of premium offerings unveiled and exhibited at ASE 2025 suggest that there’s more than enough room at large hospital systems and research institutions for the best the modality has to offer.

Echo is Great, but AI Makes it Better – Even with the significant improvements in scanner technology, image quality can only take ultrasound so far. Nearly every major CVUS vendor had unveiled custom AI native to the device, while AI firms focused on vendor agnostic software to give unique benefits like EF quantification and probe placement guidance.

Software Softens Staffing Issues – Despite cardiovascular ultrasound’s importance to the detection and diagnosis of CV diseases, sonographers staffing troubles persist. While CVUS software vendors can’t fix the sonographer shortage, many are developing tools like probe guidance and measurement algorithms to help bridge the gap between new and experienced technicians.

Ultrasound Enhancing Agent Use is Lagging – A common theme across all of our conversations with UEA makers was that most echo labs are not using UEAs as much as they could (or even should be). Though estimates vary (some say 20-30% of scans need UEAs, but only 4-6% get them), the trend is clear that injectable UEAs are underutilized.

Innovation in CVUS Exists at Every Step – While AI and hardware improvements tend to dominate the echo innovation conversation, a range of companies are working to improve the physical aspects of CVUS testing. Whether it’s Agitated Solutions removing human error from the bubble test or CardiaLine improving the ergonomics of the stress test, innovation in CVUS is everywhere.

GLS Analysis of Us2.ai’s Fully-Automated Software

Ten years after the first head-to-head comparison of 2D echocardiography, the latest review suggests Us2.ai is among the easiest to use and integrate. Read the study to learn about how Us2.ai’s software requires zero operator input, operates without human intervention, and leads to high agreement with traditional semi-automated speckle- tracking software solutions.

The Largest Registry on Plaque Analysis in CAD

What if 50% of your CCTA patients could benefit from an adjustment to their treatment plan? Read more about Heartflow’s DECIDE registry that demonstrates how Heartflow Plaque Analysis using its Plaque Staging software empowers physicians with clinical insights that lead to real-world impact.

Explore Vitrea Advanced Visualization

Discover Canon Medical Healthcare IT’s suite of advanced imaging workflows designed to increase efficiency in cardiovascular imaging, and facilitate the assessment, diagnosis, and treatment of cardiovascular diseases. These cutting-edge tools support the delivery of faster, more accurate care while integrating seamlessly into clinical workflow

The Wire

• Canon CVUS by Guardsman: Following an in-depth conversation at ASE 2025, Cardiac Wire learned first hand that Guardsman Scientific is now the exclusive U.S. distributor of Canon’s cardiovascular ultrasound lineup. Guardsman will integrate Canon’s CVUS team while taking over Canon’s CVUS installed base. The move comes amid significant competition from major ultrasound makers like GE HealthCare, Siemens Healthineers, and Philips, but Guardsman believes Canon’s product is superior and that a lifetime support model will help set them apart.

• Us2.ai Shines for HCM Detection: New results presented at ASE 2025 suggest that echo AI can be instrumental at detecting hypertrophic cardiomyopathy. Researchers at Duke University used Us2.ai’s FDA- and CE-marked AI software to develop an in-house algorithm that accurately detected HCM from routine TTEs, with AUCs of 0.95 during internal use and 0.90 during external validation. The model also properly differentiated HCM from similarly presenting conditions (amyloidosis, HTN, AS) with high accuracy. You can watch Cardiac Wire’s interview with the study’s primary author here.

• CRT Parameters for Improving Outcomes: A recent JASE meta-analysis of 51 studies found that speckle tracking echocardiography (STE) parameters can improve cardiac resynchronization therapy outcomes, since nearly 30% of CRT patients are non-responders. Researchers examined results from 11.5k heart failure patients and found that key STE parameters included dyssynchrony index (reducing clinical outcome risk by 49%), global wasted work (4.78-fold increased CRT response odds), and specific strain patterns.

• Neurescue Earns CE Mark: Neurescue received CE Mark approval for the NEURESCUE device which it designed to treat non-shockable cardiac arrest. The device uses a catheter with an inflatable balloon in the descending aorta to redirect blood flow to the heart and brain during CPR, boosting circulation within one minute. Clinical trials showed 100% physician success rates with five-minute procedure times, representing a major resuscitation breakthrough.

• Visura’s TEECAD Registry: Visura Technologies announced positive data from the TEECAD product registry at ASE 2025, showing their FDA-cleared disposable camera system safely guides TEE probe intubations with visual guidance instead of blind insertion. The study of nearly 200 patients across 16 sites found that 91% of physicians deemed TEECAD beneficial, with zero adverse events reported. The system received top navigation scores in 80% of cases, providing real-time visualization of esophageal structures during intubation procedures.

• VEST Algorithm for PAH: A novel automated EMR based VEST algorithm could accurately identify pulmonary arterial hypertension patients from routine echocardiograms. According to a study from United Therapeutics, the system showed 100% correlation with manual calculations across nearly 5k patients, finding that those with +3 VEST scores had severe PAH (mean pulmonary artery pressure 48mmHg). While 95% of referred patients with +3 scores underwent right heart catheterization, only 38% of non-referred patients did.

• BSCI Buys Elutia’s Bioenvelopes: Elutia sold its EluPro and CanGaroo bioenvelope product lines to Boston Scientific for $88M in cash, with the deal expected to close Q4 2025. The move transforms Elutia’s balance sheet by eliminating debt, resolving litigation, and providing funding for its NXT-41x breast reconstruction technology. Meanwhile the bioenvelopes will fit nicely among Boston Scientific’s drug eluting portfolio like the ELUVIA stent and may even be complementary to the AGENT DCB.

• Early SBP Measurement Has Benefits: A post hoc analysis of the DanGer Shock trial suggests early SBP measurement could help identify patient candidates for microaxial flow pump treatment. The study analyzed 351 patients with ST-elevation myocardial infarction and cardiogenic shock to determine if SBP affects microaxial flow pump therapy, finding that SBP levels significantly impacted survival rates. Patients with SBP <82 mmHg experienced significantly lower mortality risk (OR 0.34) compared to higher SBP patients (OR 0.96).

• We Need More Women in CV Research: A new systematic review confirms what many have noticed over the years, women are underrepresented in cardiology studies. Researchers conducted a systematic review of 1,000 cardiovascular trials from 2017 to 2023 and found that women comprised 41% of 1.4 million participants. Female representation was significantly lower in arrhythmia, coronary heart disease, acute coronary syndrome, and heart failure trials, but higher in obesity and pulmonary hypertension studies.

• AZ’s Baxdrostat Phase 3 Success: According to fresh results from the BaxHTN Phase 3 trial, AstraZeneca’s first-in-class aldosterone synthase inhibitor, Baxdrostat, can help lead to significant blood pressure reductions. Researchers found that Baxdrostat’s 2mg dose lowered systolic blood pressure by 15.7 mmHg from baseline (9.8 mmHg placebo-adjusted) at 12 weeks in patients with hard-to-control hypertension. The drug was well-tolerated with low hyperkalemia rates.

• Radiation Dose in Cardiac Imaging: A presentation at ESC 2025 provided intriguing data on radiation dose from different types of cardiac imaging exams. In a global survey of 747 centers and 19.4k patients, median entrance dose levels were as follows: coronary calcium scoring = 1.2 mSv; PET = 2.0 mSv; SPECT = 6.5 mSv; and coronary CT angiography = 7.4 mSv. More nuclear cardiology labs than CCTA sites met targeted dose levels (80% vs. 46%), and dose levels were lowest in Western Europe.

PIA’s Post-Processing Solution

Advanced cardiac imaging often calls for a time-consuming post-processing step, requiring costly software, hardware, and training. See how PIA provides this post-processing at lower cost, improved consistency, and greater efficiency.

Identify and Treat Cardiovascular Disease

Complex care pathways make getting patients to the next step a challenge. See how Tempus Next, an AI enabled care pathway platform, helps providers identify and reduce under treatment in cardiovascular disease by adding an intelligent layer onto their routinely generated EHR data.

Addressing Coronary Artery Disease

Learn how the AGENT™ Drug-Coated Balloon provides a new treatment option for in-stent restenosis in the U.S. Rx Only. (Sponsored by Boston Scientific)

The Resource Wire

• How Vista AI Helps Solve the Technologist Shortage: Fewer than 2% of MRI scanners are routinely used for cardiac imaging—mainly due to a shortage of trained technologists amid rising demand. Vista AI addresses this challenge by automating CMR scanning, empowering technologists of all experience levels to deliver high-quality cardiac exams consistently and efficiently.

• The All in One Cardiac Imaging Solution: Ready for an all-in-one solution that supports all of your MR and CT needs? See how Circle Cardiovascular Imaging’s cvi42 can streamline your core reading and reporting workflows within a single, customizable platform.

• Monebo’s Customers Lead the Way: Monebo’s customers span across the globe, and range from local cardiac monitoring companies to major ECG OEMs. See what they all have in common, and how the Monebo monitoring advantage might help your business.

• Optimize GDMT for Your Heart Failure Patients Between Office Visits: Don’t wait for worsening heart failure in your heart failure patients. Make proactive treatment adjustments with the CardioMEMS HF System and get regular updates on their pulmonary artery pressures.

• Siemens Healthineers ACUSON Origin Ultrasound System is Redefining CVUS: ACUSON Origin meets the demands of today’s cardiovascular care with AI-powered efficiency across adult and pediatric echo, vascular, structural heart, and EP. Streamlined workflows, intuitive walk-up usability, and advanced ergonomics empower clinicians to deliver confident, high-quality care—supporting a wide range of complex cases and clinical applications.

• Streamline Your Cardiology Imaging Workflows: See how cardiologists and their teams can streamline imaging workflows to make their cardiovascular service line more efficient, cost-effective, and patient-centered, using Merge’s cardiology solutions.

The Industry Wire

1. COVID-19 no longer a top 10 killer.
2. More of the world’s children are now obese than underweight.
3. Kaiser Permanente and Renown Health form a joint venture.
4. CMS issues guidance on cuts to Medicaid state-directed payments.
5. FTC warns healthcare employers to review noncompetes.
6. Pacs Group CFO resigns amid allegations of improper conduct.
7. Oracle challenges Epic with new AI tools for hospitals.
8. 1 in 4 Americans believe Trump admin vaccine shifts are science-based.
9. CMS rolls out last-minute changes to Medicare Plan Finder.
10. Alzheimer’s blood test could ‘revolutionize’ diagnosis.