Artificial intelligence-empowered echocardiography: an updated review of clinical management in hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a common and highly heterogeneous inherited cardiomyopathy characterized by complex clinical phenotypes and diverse disease trajectories, posing significant challenges for early diagnosis, precise phenotypic classification, and risk stratification. Owing to its noninvasive nature, repeatability, and wide availability, echocardiography remains the cornerstone imaging modality for the diagnosis and longitudinal management of HCM. However, conventional echocardiographic analysis relies heavily on operator expertise and is limited in its ability to comprehensively extract latent structural, functional, and tissue-level information embedded within imaging data. In recent years, artificial intelligence (AI), particularly deep learning, has undergone rapid development in automated echocardiographic analysis, enabling a paradigm shift from traditional morphology-based assessment toward data-driven intelligent decision-support platforms. This review systematically categorizes AI-based methods in echocardiography according to the complexity of data processing, ranging from single-frame structural and texture analysis to spatiotemporal modeling of cardiac function, multi-view representation learning, and ultimately multimodal integration incorporating diverse clinical data sources. We further summarize the clinical applications of these AI-based methods in HCM, including diagnosis and differential diagnosis, phenotype characterization, and risk prediction. In addition, current challenges are discussed, including limited interpretability, data heterogeneity, and insufficient large-scale clinical validation, and future research directions are proposed. Overall, AI-empowered echocardiography holds substantial promise for advancing precision diagnosis, risk stratification, and personalized management of HCM, facilitating a transition toward more intelligent and individualized cardiovascular care.